Provider Demographics
NPI:1093779720
Name:SAYDJARI, RAMI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMI
Middle Name:
Last Name:SAYDJARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 LAFAYETTE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933
Mailing Address - Country:US
Mailing Address - Phone:765-361-1234
Mailing Address - Fax:765-361-2267
Practice Address - Street 1:1630 LAFAYETTE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933
Practice Address - Country:US
Practice Address - Phone:765-361-1234
Practice Address - Fax:765-361-2267
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039890208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F25416Medicare UPIN
152720Medicare ID - Type Unspecified