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NPI Code Detail

MEDICARE: MR. KEITH MINTON RAMSEY M.D.

MEDICARE: MR. KEITH MINTON RAMSEY M.D.
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
1207V00000XObstetrics & Gynecology Physician036068254IL
2207V00000XObstetrics & Gynecology Physician01036485AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5M400041004OTHERINMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000090423OTHERINBLUE CROSS BLUE SHIELD
20090000637OTHERILBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487632527
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEITH MINTON RAMSEY M.D.
Provider Business Mailing Address
First Line : PO BOX 1430
Second Line :
City : PORTAGE
State : IN
Zip : 46368-9230
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-764-5380
Provider Business Practice Location Address
First Line : 2490 CENTRAL AVE
Second Line :
City : LAKE STATION
State : IN
Zip : 46405-2122
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-962-1580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 07/31/2020

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