| Annis Mohamed Bushaala Ali, MD | |
| 25 Monument Rd Ste 295, York, PA 17403-5049 | |
| (717) 356-5864 | |
| Not Available | 
| Full Name | Annis Mohamed Bushaala Ali | 
|---|---|
| Gender | Male | 
| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) | 
| Location | 25 Monument Rd Ste 295, York, Pennsylvania | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1447647904 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | MD482147 (Pennsylvania) | Secondary | 
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | MD481917 (Pennsylvania) | Primary | 
| Entity Name | Wellspan Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1669770004 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Annis Mohamed Bushaala Ali, MD 25 Monument Rd Ste 295, York, PA 17403-5049 Ph: (717) 356-5864 | Annis Mohamed Bushaala Ali, MD 25 Monument Rd Ste 295, York, PA 17403-5049 Ph: (717) 356-5864 | 
| A. Michael Borkon, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 30 Monument Rd Ste 1100, York, PA 17403 Phone: 717-851-6454 Fax: 717-851-1665 | |
| Dr. Nikhilesh M Korgaonkar, MD, MBA Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 25 Monument Rd Ste 295, York, PA 17403 Phone: 717-356-5864 Fax: 717-409-6221 | |
| Mark W Burlingame, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 30 Monument Street, Ste 1100, York, PA 17403 Phone: 717-851-6454 | |
| Dr. Ronson Joseph Madathil, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 30 Monument Rd Ste 1100, York, PA 17403 Phone: 717-851-6454 Fax: 717-851-1665 | |
| Scott Tiedebohl, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 25 Monument Rd Ste 295, York, PA 17403 Phone: 717-356-5864 Fax: 717-409-6221 |