MEDICARE: DR. RAMAZ METREVELI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	C10006581	DE
2	208600000X	Surgery Physician	MD432554	PA

General Provider Information

NPI Number	:	1457350159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMAZ METREVELI M.D.

Provider Business Mailing Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 207
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5408
Country	:	US
Telephone Number	:	302-994-3128
Fax Number	:	302-998-6991

Provider Business Practice Location Address
First Line	:	1941 LIMESTONE RD
Second Line	:	SUITE 207
City	:	WILMINGTON
State	:	DE
Zip	:	19808-5408
Country	:	US
Telephone Number	:	302-994-3128
Fax Number	:	302-998-6991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	02/04/2022

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