Individual
AHMAD S ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7240 SHADELAND STATION, SUITE 300, INDIANAPOLIS, IN 46256-3944
(317) 621-6060
(317) 355-6965
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71003719A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201039100
—
IN
01
—
M400058907
MEDICARE PIN TERMED
IN
01
—
P01189201
RR MEDICARE PTAN
IN
Enumeration date
10/25/2011
Last updated
11/07/2014
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