Provider Demographics
NPI:1073537130
Name:ALI, MUHAMMAD M (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:M
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 N GLEN WOOD CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-1708
Mailing Address - Country:US
Mailing Address - Phone:316-613-1078
Mailing Address - Fax:316-854-0809
Practice Address - Street 1:1427 N GLEN WOOD CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-1708
Practice Address - Country:US
Practice Address - Phone:316-613-1078
Practice Address - Fax:316-854-0809
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361126442084P0804X
KS04-302182084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry