Basic Information
| Provider Information | |||||||||
| NPI: | 1063798742 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARIATI | ||||||||
| FirstName: | RAMIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1030 RIVER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019321030 | ||||||||
| FaxNumber: | 6019362390 | ||||||||
| Practice Location | |||||||||
| Address1: | 1030 RIVER OAKS DR | ||||||||
| Address2: | |||||||||
| City: | FLOWOOD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019321030 | ||||||||
| FaxNumber: | 6019362390 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2011 | ||||||||
| LastUpdateDate: | 10/26/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | PENDING | MS | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.