Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 0101044267 | VA |
NPI | 1457448995 |
---|---|
Provider Name | M Karim Ali |
First Address | Reston, VA 20190-5896 |
Second Address | Reston, VA 20190-5896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 12/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006503322 | (05) | VA |
E38517 | (02) | VA |