=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689612236
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAMAN TULI, MD, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2006
-----------------------------------------------------
Last Update Date | 05/19/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10810 DARNESTOWN RD SUITE 202
-----------------------------------------------------
City | GAITHERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20878-2675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-424-1780
-----------------------------------------------------
Fax | 301-424-7148
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10810 DARNESTOWN RD SUITE 202
-----------------------------------------------------
City | GAITHERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20878-2675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-424-1780
-----------------------------------------------------
Fax | 301-424-7148
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RAMAN REKHA TULI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 301-424-1780
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | D19609
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | D19609
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------