Provider Demographics
NPI:1053351528
Name:ALI, NADEEM S (MD)
Entity type:Individual
Prefix:
First Name:NADEEM
Middle Name:S
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:P.O. BOX 626
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-282-6099
Practice Address - Street 1:30 WEST COLE ROAD
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-282-3349
Practice Address - Fax:207-282-6099
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME016399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME406390099Medicaid
ME1053351528Medicaid
MEI13191Medicare UPIN
ME406390099Medicaid
MEME0837Medicare ID - Type Unspecified