Provider Demographics
NPI:1578574885
Name:RAWLANI, RAMESHLAL M (MD)
Entity Type:Individual
Prefix:
First Name:RAMESHLAL
Middle Name:M
Last Name:RAWLANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2808 WOODBERRY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-6652
Mailing Address - Country:US
Mailing Address - Phone:573-446-5960
Mailing Address - Fax:
Practice Address - Street 1:600 EAST 5TH STREET
Practice Address - Street 2:FULTON STATE HOSPITAL
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251
Practice Address - Country:US
Practice Address - Phone:573-592-4100
Practice Address - Fax:573-592-3023
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1054902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205039209Medicaid
G86177Medicare UPIN
MO081050022Medicare PIN
MO081050022Medicare ID - Type Unspecified