Provider Demographics
NPI:1699707653
Name:ALI, MUHAMMAD (MD,)
Entity type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:
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 1:3450 N BEAUREGARD ST
Mailing Address - Street 2:#2
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1200
Mailing Address - Country:US
Mailing Address - Phone:703-998-0766
Mailing Address - Fax:703-931-3562
Practice Address - Street 1:6715 LITTLE RIVER TURNPIKE SUITE 304
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:703-998-0766
Practice Address - Fax:703-931-3562
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047480207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006078265Medicaid
VA006078265Medicaid
586230Medicare ID - Type Unspecified