MEDICARE: WILLIAM R 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
1	207RG0100X	Gastroenterology Physician	5101010597	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346210317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM R RAMINICK D.O.

Provider Business Mailing Address
First Line	:	DEPT 203901
Second Line	:	P O BOX 67000
City	:	DETROIT
State	:	MI
Zip	:	48267
Country	:	US
Telephone Number	:	248-471-8982
Fax Number	:	248-471-9978

Provider Business Practice Location Address
First Line	:	23133 ORCHARD LAKE RD STE 200
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-3268
Country	:	US
Telephone Number	:	248-579-9220
Fax Number	:	248-471-9978

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	09/24/2018

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