Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | RL13723 | ND |
Y | 111NI0900X | Internist | RL13723 | ND |
N | 207RG0300X | Geriatric Medicine | 15268 | ND |
NPI | 1033598214 |
---|---|
Provider Name | Syed Haris Ali |
First Address | Fargo, ND 58103-4499 |
Second Address | Austin, MN 55912-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2015 |
Last Update Date | 15/11/2021 |