Provider Demographics
NPI:1235183203
Name:WALI, RAMI S (MD)
Entity Type:Individual
Prefix:
First Name:RAMI
Middle Name:S
Last Name:WALI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6920 POINTE INVERNESS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:2510 E DUPONT RD STE 108
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1601
Practice Address - Country:US
Practice Address - Phone:260-434-6076
Practice Address - Fax:260-416-5898
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-09-30
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Provider Licenses
StateLicense IDTaxonomies
IN01074649A207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181328902Medicaid
TX181328901Medicaid
TX8G7778Medicare PIN
TX181328902Medicaid
TX8G7779Medicare PIN