Basic Information
| Provider Information | |||||||||
| NPI: | 1326527284 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SALIB | ||||||||
| FirstName: | RAMY | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 OAKCREST ST | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522465194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193847222 | ||||||||
| FaxNumber: | 3193847822 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 OAKCREST ST | ||||||||
| Address2: | |||||||||
| City: | IOWA CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 522465194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193847222 | ||||||||
| FaxNumber: | 3193847822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2018 | ||||||||
| LastUpdateDate: | 01/31/2019 | ||||||||
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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 | 207Q00000X | R-11374 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | R-11374 | 05 | IA | MEDICAID |