Healthcare Provider Details

I. General information

NPI: 1689612236
Provider Name (Legal Business Name): RAMAN TULI, MD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 DARNESTOWN RD SUITE 202
GAITHERSBURG MD
20878-2675
US

IV. Provider business mailing address

10810 DARNESTOWN RD SUITE 202
GAITHERSBURG MD
20878-2675
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-1780
  • Fax: 301-424-7148
Mailing address:
  • Phone: 301-424-1780
  • Fax: 301-424-7148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberD19609
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD19609
License Number StateMD

VIII. Authorized Official

Name: DR. RAMAN REKHA TULI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-424-1780