Provider Demographics
NPI:1619195146
Name:KILANI, RAMSEY KHAIR (MD)
Entity Type:Individual
Prefix:
First Name:RAMSEY
Middle Name:KHAIR
Last Name:KILANI
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 1:2115 E SOUTHERN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-5304
Mailing Address - Country:US
Mailing Address - Phone:480-545-8119
Mailing Address - Fax:480-926-8332
Practice Address - Street 1:2115 E SOUTHERN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5304
Practice Address - Country:US
Practice Address - Phone:480-545-8119
Practice Address - Fax:480-926-8332
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ435092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z145026OtherMEDICARE