Basic Information
| Provider Information | |||||||||
| NPI: | 1104222603 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAI | ||||||||
| FirstName: | MOHAMMAD | ||||||||
| MiddleName: | ALI | ||||||||
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| Credential: | M.D.,PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2830 VICTORY PARKWAY | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452631723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132453104 | ||||||||
| FaxNumber: | 5135855511 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 EDEN AVENUE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452190001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135846977 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2014 | ||||||||
| LastUpdateDate: | 11/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 35135704 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 390200000X | 57.024138 | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.