Healthcare Provider Details

I. General information

NPI: 1699743724
Provider Name (Legal Business Name): MICHAEL A RAMOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 W 13TH ST
PUEBLO CO
81003-3704
US

IV. Provider business mailing address

PO BOX 560825
DENVER CO
80256-0825
US

V. Phone/Fax

Practice location:
  • Phone: 719-595-7474
  • Fax: 719-595-7199
Mailing address:
  • Phone: 719-595-7580
  • Fax: 719-545-0176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27612
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberDR.0027612
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: