MEDICARE: DR. BASEL RAMLAWI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	003072	NY
2	174400000X	Specialist	N4690	TX
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	0101259359	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00829654	OTHER	TX	MEDICARE RAILROAD
2	P01170499	OTHER	TX	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1265692479	OTHER	TX	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265692479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASEL RAMLAWI M.D.

Provider Business Mailing Address
First Line	:	100 E LANCASTER AVE STE 356
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3433
Country	:	US
Telephone Number	:	281-979-1780
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE STE 356
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3433
Country	:	US
Telephone Number	:	281-979-1780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	11/11/2022

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