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NPI Code Detail

MEDICARE: MINDY RAMINICK D.O.

MEDICARE: MINDY RAMINICK D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician5151010997MI
2207RN0300XNephrology Physician5101026106MI

General Provider Information

NPI Number : 1306292438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINDY RAMINICK D.O.
Provider Business Mailing Address
First Line : 1512 MOHAWK AVE
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-3334
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5280 METROPOLITAN PKWY
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4005
Country : US
Telephone Number : 248-290-3111
Fax Number : 248-290-3100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2016
Last Update Date : 06/30/2022

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