Provider Demographics
NPI:1346366911
Name:JEBRAILI, RAMIN M (MD)
Entity Type:Individual
Prefix:MR
First Name:RAMIN
Middle Name:M
Last Name:JEBRAILI
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 1:3 WASHINGTON CIRCLE NW
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037
Mailing Address - Country:US
Mailing Address - Phone:202-822-6464
Mailing Address - Fax:202-822-0645
Practice Address - Street 1:3 WASHINGTON CIRCLE NW
Practice Address - Street 2:SUITE 309
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-822-6464
Practice Address - Fax:202-822-0645
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD19710207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD340200201Medicaid
MD340200201Medicaid
G38141Medicare UPIN