Provider Demographics
NPI:1437262318
Name:RAMMOUNI, MAJED A (MD)
Entity Type:Individual
Prefix:
First Name:MAJED
Middle Name:A
Last Name:RAMMOUNI
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 1:21000 E 12 MILE RD
Mailing Address - Street 2:STE 105
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1156
Mailing Address - Country:US
Mailing Address - Phone:586-585-2570
Mailing Address - Fax:586-585-2574
Practice Address - Street 1:23600 HARPER AVE
Practice Address - Street 2:
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080
Practice Address - Country:US
Practice Address - Phone:586-585-2570
Practice Address - Fax:586-585-2574
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMR068981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
7819328OtherAETNA
MIC7156OtherMCARE
1105001811OtherBCBS
MI4243830Medicaid
P00020733OtherMEDICARE RR#
124095OtherCARE CHOICES
P104241OtherBCN
G97751OtherHAP
124095OtherCARE CHOICES
MI4243830Medicaid