Basic Information
| Provider Information | |||||||||
| NPI: | 1467460345 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIVELEK | ||||||||
| FirstName: | ALI | ||||||||
| MiddleName: | CAHID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9910 FRANKLIN SQUARE DR STE 2110 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212364902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109336423 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 N CAROLINE ST STE 3223A | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212870006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106143896 | ||||||||
| FaxNumber: | 4109558449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 08/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 2003003231 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 2085N0904X | 42032 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0202X | 42032 | KY | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085N0904X | D31447 | MD | Y | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology |
No ID Information.