Provider Demographics
NPI:1497192298
Name:ALBAZ, RAMA (MD)
Entity Type:Individual
Prefix:
First Name:RAMA
Middle Name:
Last Name:ALBAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13540 HULL STREET RD
Mailing Address - Street 2:ST. FRANCIS FAMILY MEDICINE
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2107
Mailing Address - Country:US
Mailing Address - Phone:804-739-6142
Mailing Address - Fax:804-739-8923
Practice Address - Street 1:13540 HULL STREET RD
Practice Address - Street 2:ST. FRANCIS FAMILY MEDICINE
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-739-6142
Practice Address - Fax:804-739-8923
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101260486207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06778OtherGROUP PTAN
VAC06115OtherGROUP PTAN
VAC09633OtherGROUP PTAN