Healthcare Provider Details

I. General information

NPI: 1215960125
Provider Name (Legal Business Name): STEVEN FREDERICK RAMUS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28800 RYAN RD STE 120
WARREN MI
48092-4269
US

IV. Provider business mailing address

28800 RYAN RD STE 120
WARREN MI
48092-4269
US

V. Phone/Fax

Practice location:
  • Phone: 586-558-2860
  • Fax: 586-558-4624
Mailing address:
  • Phone: 586-558-2860
  • Fax: 586-558-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601004697
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: