Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2007-01575 | NC |
Y | 207RP1001X | Pulmonary Disease | 200701575 | NC |
NPI | 1083800965 |
---|---|
Provider Name | Dr. Mir-Omar Ali |
First Address | Clayton, NC 27520-4824 |
Second Address | Clayton, NC 27520-4824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 11/11/2019 |