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Individual

DR. MOHAMMED Y ALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1630 45TH AVE, MUNSTER, IN 46321-3963
(219) 924-3252
Mailing address
342 E 109TH AVE, CROWN POINT, IN 46307-8693
(219) 310-2550

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01029782
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100318960
IN
01
5171410002
DMERC
IN
Enumeration date
03/14/2006
Last updated
08/28/2012
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