Healthcare Provider Details

I. General information

NPI: 1922155100
Provider Name (Legal Business Name): JOHN MICHAEL RAMIREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 12/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 NORTHRISE DR
LAS CRUCES NM
88011
US

IV. Provider business mailing address

2735 NORTHRISE DR
LAS CRUCES NM
88011-0897
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-0329
  • Fax: 575-521-3606
Mailing address:
  • Phone: 575-522-0329
  • Fax: 575-521-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number85-272
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number85-272
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: