Provider Demographics
NPI:1386441012
Name:TINAI, ALI MAHMOUD
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:MAHMOUD
Last Name:TINAI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 CREEK DR SE APT 1A
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49512-2828
Mailing Address - Country:US
Mailing Address - Phone:517-974-3311
Mailing Address - Fax:
Practice Address - Street 1:3125 CREEK DR SE APT 1A
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-2828
Practice Address - Country:US
Practice Address - Phone:517-974-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health