Healthcare Provider Details

I. General information

NPI: 1184799918
Provider Name (Legal Business Name): MARCO A RAMOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 07/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2210 NEIDHAMMER DR
BAY CITY MI
48706-9497
US

IV. Provider business mailing address

4 COLUMBUS AVE STE 240
BAY CITY MI
48708-6472
US

V. Phone/Fax

Practice location:
  • Phone: 888-569-4010
  • Fax:
Mailing address:
  • Phone: 888-569-4010
  • Fax: 989-509-5967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMRO77734
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: