Provider Demographics
NPI:1326236027
Name:RAMIN RAHIMI D.O.
Entity Type:Organization
Organization Name:RAMIN RAHIMI D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-447-4090
Mailing Address - Street 1:4955 E BELTLINE AVE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-1097
Mailing Address - Country:US
Mailing Address - Phone:616-447-4090
Mailing Address - Fax:616-447-4098
Practice Address - Street 1:4955 E BELTLINE AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1097
Practice Address - Country:US
Practice Address - Phone:616-447-4090
Practice Address - Fax:616-447-4098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N84390Medicare PIN