Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101259856 | VA |
N | 207RI0200X | Infectious Disease | 260942 | MA |
N | 207RI0200X | Infectious Disease | 27208 | NE |
N | 207RI0200X | Infectious Disease | 52994 | CT |
NPI | 1053676858 |
---|---|
Provider Name | Dr. Mir Akbar Ali |
First Address | Prince George, VA 23875-1275 |
Second Address | Prince George, VA 23875-1275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2012 |
Last Update Date | 21/04/2020 |