Healthcare Provider Details

I. General information

NPI: 1366541856
Provider Name (Legal Business Name): BENJAMIN S. RAMIREZ MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S GRAHAM RD
FLINT MI
48532-3538
US

IV. Provider business mailing address

1425 S GRAHAM RD
FLINT MI
48532-3538
US

V. Phone/Fax

Practice location:
  • Phone: 810-230-1288
  • Fax: 810-230-1058
Mailing address:
  • Phone: 810-230-1288
  • Fax: 810-230-1058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301043485
License Number StateMI

VIII. Authorized Official

Name: DR. BENJAMIN SALAZAR RAMIREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 810-230-1288