Provider Demographics
NPI:1881898898
Name:RAMA MEDICAL GROUP
Entity type:Organization
Organization Name:RAMA MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAWWAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ALKAYYALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-781-1935
Mailing Address - Street 1:PO BOX 110925
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37222-0925
Mailing Address - Country:US
Mailing Address - Phone:615-781-1935
Mailing Address - Fax:615-781-1936
Practice Address - Street 1:397 WALLACE RD
Practice Address - Street 2:SUITE C 303
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4854
Practice Address - Country:US
Practice Address - Phone:615-781-1935
Practice Address - Fax:615-781-1936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10067551OtherAMERIGROUP
TN3097984Medicaid
G21158Medicare PIN
TN3731879Medicare ID - Type Unspecified