Individual
DR. ALI MOKHTARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 351-0450
(614) 351-1125
Mailing address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 351-0450
(614) 351-1125
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35035614
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000117451
ANTHEM BLUE CROSS/BLUE SH
OH
01
—
011532081
RAILROAD MEDICARE
OH
05
—
0226197
—
OH
Enumeration date
09/24/2006
Last updated
07/13/2007
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