Provider Demographics
NPI:1427477363
Name:ELTARABOULSI, RAMI RAOUF (MD)
Entity type:Individual
Prefix:
First Name:RAMI
Middle Name:RAOUF
Last Name:ELTARABOULSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:950 CAROLINA BELL RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18111 PRINCE PHILIP DR STE 323
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1507
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:301-774-1799
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101260455207R00000X
390200000X
MDD0089215207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty