Provider Demographics
NPI:1902053234
Name:MOHAMEDALI, MOHAMED G (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:G
Last Name:MOHAMEDALI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:4967 CROOKS RD
Mailing Address - Street 2:STE 130
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5801
Mailing Address - Country:US
Mailing Address - Phone:248-952-1601
Mailing Address - Fax:248-952-1614
Practice Address - Street 1:4100 JOHN R
Practice Address - Street 2:KARMANOS CANCER CENTER
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:734-464-0887
Practice Address - Fax:734-402-0254
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2015-07-29
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Provider Licenses
StateLicense IDTaxonomies
MI4301102710207R00000X
PAMD443705207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine