MEDICARE: ALFREDO C. RAMIREZ, MD PLLC

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	2084P0804X	Child & Adolescent Psychiatry Physician	12694	AZ
2	2084P0800X	Psychiatry Physician	12694	AZ

General Provider Information

NPI Number	:	1619164829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFREDO C. RAMIREZ, MD PLLC

Provider Business Mailing Address
First Line	:	P.O. BOX 15399
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85708
Country	:	US
Telephone Number	:	520-663-0689
Fax Number	:	520-663-0690

Provider Business Practice Location Address
First Line	:	8684 E SEMPLE STREET
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85747
Country	:	US
Telephone Number	:	520-663-0688
Fax Number	:	520-663-0690

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	DR. ALFREDO C. RAMIREZ
Credential	:	MD
Telephone Number	:	520-663-0688

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	02/01/2010

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