Healthcare Provider Details

I. General information

NPI: 1205849304
Provider Name (Legal Business Name): ROLA RIMAWI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 FORD RD SUITE A
PHILADELPHIA PA
19131-2039
US

IV. Provider business mailing address

615 CHESTNUT ST 14TH FLOOR
PHILADELPHIA PA
19106-4404
US

V. Phone/Fax

Practice location:
  • Phone: 215-879-9346
  • Fax: 215-879-9082
Mailing address:
  • Phone:
  • Fax: 215-955-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229695
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD432520
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: