Healthcare Provider Details

I. General information

NPI: 1750685962
Provider Name (Legal Business Name): RAMSES BAGUIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 OLD HIGHWAY 63 S STE 102
COLUMBIA MO
65201-6092
US

IV. Provider business mailing address

1316 OLD HIGHWAY 63 S STE 102
COLUMBIA MO
65201-6092
US

V. Phone/Fax

Practice location:
  • Phone: 573-875-8838
  • Fax:
Mailing address:
  • Phone: 573-875-8838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2011002336
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: