Provider Demographics
NPI:1871772756
Name:MASOOD, ALI K (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:K
Last Name:MASOOD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4050 INNSLAKE DRIVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060
Mailing Address - Country:US
Mailing Address - Phone:804-521-5315
Mailing Address - Fax:804-521-5312
Practice Address - Street 1:1602 SKIPWITH RD
Practice Address - Street 2:HENRICO DOCTORS HOSPITAL FOREST CAMPUS
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5205
Practice Address - Country:US
Practice Address - Phone:804-289-4951
Practice Address - Fax:804-289-5623
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2009-09-23
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Provider Licenses
StateLicense IDTaxonomies
VA0101242549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2760675OtherCIGNA
VA1871772756Medicaid
VA691490OtherSOUTHERN HEALTH
VA302011OtherANTHEM
VA9030061OtherAETNA
VAP00601112OtherMEDICARE RAILROAD
VA691490OtherSOUTHERN HEALTH