Provider Demographics
NPI:1316125008
Name:ALI, SADEEM A (MD)
Entity type:Individual
Prefix:
First Name:SADEEM
Middle Name:A
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:304 4TH AVE APT 37
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2598
Mailing Address - Country:US
Mailing Address - Phone:320-321-7271
Mailing Address - Fax:
Practice Address - Street 1:521 MOYE BLVD
Practice Address - Street 2:ECU PHYSICIANS INTERNAL MEDICINE
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2849
Practice Address - Country:US
Practice Address - Phone:252-744-3229
Practice Address - Fax:252-744-3924
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2017-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN49385207R00000X
NC2006-01682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN49385OtherSTATE MEDICAL LICENSE
NC1316125008Medicaid
NC18520OtherBCBS NC
NC2006-01682OtherSTATE MEDICAL LICENSE
NC18520OtherBCBS NC