Individual
AZRA J ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
89 FOSTER ST, PEABODY, MA 01960-8925
(978) 532-4903
(978) 532-4995
Mailing address
89 FOSTER ST, PEABODY, MA 01960-8925
(978) 532-4903
(978) 532-4995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
153455
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320912
—
MA
01
—
153455
TUFTS
MA
01
—
710534
HARVARD PILGRIM
MA
01
—
J19702
BCBS OF MA
MA
Enumeration date
06/05/2006
Last updated
03/07/2013
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