Provider Demographics
NPI:1962710582
Name:ALI, ABDALLAH (MD)
Entity type:Individual
Prefix:DR
First Name:ABDALLAH
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 1:1400 W PLEASANT VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134
Mailing Address - Country:US
Mailing Address - Phone:440-882-6595
Mailing Address - Fax:
Practice Address - Street 1:1400 W PLEASANT VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134
Practice Address - Country:US
Practice Address - Phone:440-882-6595
Practice Address - Fax:603-420-8704
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.121074207Q00000X
OH390200000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4OtherHMHP