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General NPI Number Information
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NPI Number | 1174720205
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Entity Type | Individual
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Provider Name | RAMI MORTADA MD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 9300 E 29TH ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67226-2183
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Country | US
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Telephone | 316-500-6000
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Fax | 888-698-4752
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Provider Business Mailing Address
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Address Line | 9300 E 29TH ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67226-2183
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Country | US
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Telephone | 316-500-6000
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Fax | 888-698-4752
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 04-35481
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License Number State | KS
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