Individual
DR. MUSTAFA MOHAMMED ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 741-3000
Mailing address
2150 PENNSYLVANIA AVE NW, WASHINGTON, DC 20037-3201
(202) 741-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.125203
IL
207RN0300X
Nephrology Physician
036.125203
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036125203
—
IL
01
—
3932056
BCBS
IL
01
—
721089
AETNA
IL
Enumeration date
08/25/2009
Last updated
05/21/2015
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