Muazzam Ali, MD
Individual provider Active NPI Internal Medicine Physician · Johnson City, TN
NPI 1730617432 · NPPES record last updated Sep 21, 2020
Key facts
- NPI
- 1730617432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 61642 (TN)
- Practice address
- 325 N State of Franklin Rd
Johnson City, TN 37604-6056 - Phone
- (423) 439-7280
- Fax
- (423) 439-7314
- NPI assigned
- May 25, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61642 | TN | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 61642 | TN | Yes |
Addresses
Primary practice location
325 N State of Franklin Rd
Johnson City, TN 37604-6056
Mailing address
69 Dogwood Avenue
Mountain Home, TN 37684
Phone (609) 442-1586
Other practice location 1
325 N State Of Franklin Rd
Johnson City, TN 37604-6056
Phone (423) 439-7280
Other practice location 2
69 Dogwood Avenue
Mountain Home, TN 37684
Phone (609) 442-1586
Other providers in Johnson City, TN
- Crystal B Aldredge
- Alexander Prosthetics & Orthotics Inc
- Charles Alexander
- Rebecca Ann Alexander
- Ariel Alexandroni
- Harold Wayne Alison
- Nancy Judaun Alison
- Allcare Dental & Dentures
- Allen Allied Healthcare Inc.
- Alixandria Allen
All providers in Johnson City, TN · Internal Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.