Provider Demographics
NPI:1659399624
Name:OWERA, RAMI S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMI
Middle Name:S
Last Name:OWERA
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 1:4724 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2339
Mailing Address - Country:US
Mailing Address - Phone:850-696-4000
Mailing Address - Fax:850-444-7057
Practice Address - Street 1:4724 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2339
Practice Address - Country:US
Practice Address - Phone:850-696-4000
Practice Address - Fax:850-432-2532
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD 29551207RH0003X
FLME103254207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL111829Medicaid
FL145P9OtherBCBS
FL5877719OtherCIGNA
FL7515208OtherAENTA
FLCK170ZOtherMEDICARE PTAN
FL001514700Medicaid
FLP01428447OtherRR MEDICARE
AL102I834616OtherMEDICARE PTAN
FL378467OtherAVMED
FL1209591OtherWELLCARE
AL102I834616OtherMEDICARE PTAN