Provider Demographics
NPI:1679585798
Name:ALI, MOHSIN (MD)
Entity type:Individual
Prefix:DR
First Name:MOHSIN
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CUMBERLAND BND
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1805
Mailing Address - Country:US
Mailing Address - Phone:615-726-3340
Mailing Address - Fax:615-743-1679
Practice Address - Street 1:801 N HOLTZCLAW AVE # 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1211
Practice Address - Country:US
Practice Address - Phone:866-816-0433
Practice Address - Fax:615-743-1679
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN403822084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00632770OtherPALMETTO GBA PTAN
TN3831960Medicaid
600006797OtherMAGELLAN
4143329OtherBLUE CROSS BLUE SHIELD
P00632770OtherPALMETTO GBA PTAN
3831960Medicare PIN