Healthcare Provider Details

I. General information

NPI: 1649299108
Provider Name (Legal Business Name): RAUL E RAMIREZ ACEVEDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 W GOVERNOR RD 3RD FLOOR, SUITE 320
HERSHEY PA
17033-2307
US

IV. Provider business mailing address

732 WEABER AVE
PALMYRA PA
17078-9104
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-4751
  • Fax: 717-531-6139
Mailing address:
  • Phone: 210-627-1785
  • Fax: 717-531-6139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD447224
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: