Individual
DR. TALIB Y ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-9612
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36101168
IL
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
36101168
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36101168
ILLINOIS STATE LICENSE
IL
Enumeration date
08/18/2006
Last updated
09/08/2021
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