Healthcare Provider Details

I. General information

NPI: 1255674792
Provider Name (Legal Business Name): ADRIANA GABRIELA RAMIREZ MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 PARK ST
NEW HAVEN CT
06519-1110
US

IV. Provider business mailing address

1875 RIDGEMONT LN
DECATUR GA
30033-4051
US

V. Phone/Fax

Practice location:
  • Phone: 864-650-2973
  • Fax:
Mailing address:
  • Phone: 864-650-2973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101271677
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number91634
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number75623
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: