Basic Information
Provider Information
NPI: 1699202713
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMI
FirstName: SALOMI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5701 BOW POINTE DR STE 100
Address2:  
City: CLARKSTON
State: MI
PostalCode: 483463199
CountryCode: US
TelephoneNumber: 2486252621
FaxNumber: 2486252622
Practice Location
Address1: 5701 BOW POINTE DR STE 100
Address2:  
City: CLARKSTON
State: MI
PostalCode: 483463199
CountryCode: US
TelephoneNumber: 2486252621
FaxNumber: 2486252622
Other Information
ProviderEnumerationDate: 05/19/2017
LastUpdateDate: 08/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X5101025426MIY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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