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
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Mailing Address - Street 1:200 E 89TH AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7318
Mailing Address - Country:US
Mailing Address - Phone:219-756-2900
Mailing Address - Fax:219-756-2910
Practice Address - Street 1:3691 WILLOWCREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-5000
Practice Address - Country:US
Practice Address - Phone:219-921-1444
Practice Address - Fax:219-921-5303
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-06-29
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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