Provider Demographics
NPI:1861693202
Name:ALI SULEIMAN MD INC
Entity type:Organization
Organization Name:ALI SULEIMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GHADA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SULEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-255-7878
Mailing Address - Street 1:200 E BUNTING LN
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3678
Mailing Address - Country:US
Mailing Address - Phone:304-255-7878
Mailing Address - Fax:304-256-0060
Practice Address - Street 1:242 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2641
Practice Address - Country:US
Practice Address - Phone:304-255-7878
Practice Address - Fax:304-256-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16913174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810009767Medicaid
WVF38286Medicare UPIN
WV3810009767Medicaid