Healthcare Provider Details

I. General information

NPI: 1215905773
Provider Name (Legal Business Name): HAZIM RIMAWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 MERIDIAN ST STE 110
ANDERSON IN
46016
US

IV. Provider business mailing address

2020 MERIDIAN ST STE 110
ANDERSON IN
46016-4343
US

V. Phone/Fax

Practice location:
  • Phone: 765-683-3245
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01052824A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: