Provider Demographics
NPI:1730403056
Name:SHARON ALI MD LLC
Entity type:Organization
Organization Name:SHARON ALI MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-843-3627
Mailing Address - Street 1:4411 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3525
Mailing Address - Country:US
Mailing Address - Phone:419-843-3627
Mailing Address - Fax:419-843-9697
Practice Address - Street 1:4411 N HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3525
Practice Address - Country:US
Practice Address - Phone:419-843-3627
Practice Address - Fax:419-843-9697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35094611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty