MEDICARE: DR. DARREN JEROME RAMSEY

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	122300000X	Dentist	30.024652	OH
2	122300000X	Dentist	9736	SC
3	122300000X	Dentist	DN122579	GA
4	122300000X	Dentist	12162	TN
5	122300000X	Dentist	10285	NC

General Provider Information

NPI Number	:	1376900795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN JEROME RAMSEY

Provider Business Mailing Address
First Line	:	5110 PARK RD STE 2A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3745
Country	:	US
Telephone Number	:	704-255-5089
Fax Number	:

Provider Business Practice Location Address
First Line	:	5110 PARK RD STE 2A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3745
Country	:	US
Telephone Number	:	704-255-5089
Fax Number	:

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

Provider Enumeration Date	:	01/15/2016
Last Update Date	:	12/05/2024

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