1831415314 NPI number — ALI NASSER MD PC2

Table of content: (NPI 1831415314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831415314 NPI number — ALI NASSER MD PC2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALI NASSER MD PC2
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TOWN MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831415314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9800 CONANT
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
HAMTRAMCK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-875-9000
Provider Business Mailing Address Fax Number:
313-875-9021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9800 CONANT ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
HAMTRAMCK
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48212-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-875-9000
Provider Business Practice Location Address Fax Number:
313-875-9021
Provider Enumeration Date:
04/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
NASSER
Authorized Official First Name:
ALI
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
313-875-9000

Provider Taxonomy Codes

  • Taxonomy code: 173000000X , with the licence number:  4301077843 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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