Provider Demographics
NPI:1013025220
Name:ALI, ASEM H (MD / MBBS)
Entity type:Individual
Prefix:DR
First Name:ASEM
Middle Name:H
Last Name:ALI
Suffix:
Gender:M
Credentials:MD / MBBS
Other - Prefix:
Other - First Name:ASEM
Other - Middle Name:HASSAN
Other - Last Name:ALICEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:960 MASSACHUSETTS AVE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 HARRISON AVE, FL 2
Practice Address - Street 2:PRESTON BLDG, ENDOCRINOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2309
Practice Address - Country:US
Practice Address - Phone:617-638-7470
Practice Address - Fax:617-638-7449
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA260283207RE0101X, 207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10100814AMedicaid
OH3141513Medicaid