Provider Demographics
NPI:1053358580
Name:MUSLEH, RAMI W (PA C)
Entity type:Individual
Prefix:MR
First Name:RAMI
Middle Name:W
Last Name:MUSLEH
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 KEILMAN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9406
Mailing Address - Country:US
Mailing Address - Phone:219-365-0220
Mailing Address - Fax:219-365-0226
Practice Address - Street 1:9615 KEILMAN ST
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9406
Practice Address - Country:US
Practice Address - Phone:219-365-0220
Practice Address - Fax:219-365-0226
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2025-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10000752A363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0362388OtherANTHEM
IN129164100OtherINDIANA DEPT OF LABOR
IN129164100OtherINDIANA DEPT OF LABOR
INQ37482Medicare UPIN