Healthcare Provider Details

I. General information

NPI: 1568580892
Provider Name (Legal Business Name): WALESKA MICHELLE PABON-RAMOS MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD DUKE NORTH DUMC 3808
DURHAM NC
27710-0999
US

IV. Provider business mailing address

3060 WHISPERWOOD DR APT 409
ANN ARBOR MI
48105-3418
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-0139
  • Fax: 919-613-2680
Mailing address:
  • Phone: 617-271-4660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number163179
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: