Provider Demographics
NPI:1548635121
Name:ALI ENDOCRINOLOGY PC
Entity type:Organization
Organization Name:ALI ENDOCRINOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-204-1652
Mailing Address - Street 1:28001 SCHOENHERR RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-4396
Mailing Address - Country:US
Mailing Address - Phone:586-365-7555
Mailing Address - Fax:586-365-7560
Practice Address - Street 1:28001 SCHOENHERR RD STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4396
Practice Address - Country:US
Practice Address - Phone:810-985-6227
Practice Address - Fax:810-985-6221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301101847207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty