Provider Demographics
NPI:1548500333
Name:ALI, SABLAA (DO)
Entity type:Individual
Prefix:
First Name:SABLAA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5490 WESSEX CT APT 201
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2682
Mailing Address - Country:US
Mailing Address - Phone:954-682-8602
Mailing Address - Fax:
Practice Address - Street 1:3311 PRESCOTT RD STE 415
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3985
Practice Address - Country:US
Practice Address - Phone:318-528-4455
Practice Address - Fax:318-528-4466
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101024368207RE0101X
LA331375207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1548500333Medicaid