Most Relevant Information
Provider Data
| NPI Number: | 1003344656 |
| Provider Name: | ALI HASAN EBRAHIM M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2084N0400X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 2022003405 |
Most Important Dates
| Enumeration Date: | 05/26/2017 |
| Last Updated: | 07/07/2022 |
Provider Practice Location
1602 N 2ND ST
CLINTON
MO
647351192
Practice Location Phone/Fax
| Phone: | 6608855511 |
| Fax: |
Provider Mailing Location
1602 N 2ND ST
CLINTON
MO
647351192
Provider Mailing Phone/Fax
| Phone: | 6608855511 |
| Fax: |
Suggested EMR
Neurology EMR