Provider Demographics
NPI:1982679585
Name:RAMI, PARAG M (MD)
Entity type:Individual
Prefix:DR
First Name:PARAG
Middle Name:M
Last Name:RAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8375 W LA CAILLE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1305
Mailing Address - Country:US
Mailing Address - Phone:623-628-6193
Mailing Address - Fax:
Practice Address - Street 1:1304 FAWCETT AVE STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1900
Practice Address - Country:US
Practice Address - Phone:253-761-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3324802085R0202X
IN01067581A2085R0204X
AZ330432085R0202X, 2085R0204X
CAA1024532085R0204X
WAMD610120332085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ871831Medicaid
AZ1Z7077OtherHEALTH NET OF AZ
AZAZ0761870OtherBCBSAZ
AZ1Z7077OtherHEALTH NET OF AZ
AZ871831Medicaid
AZP00149131Medicare PIN
IN063280BBBBMedicare PIN