MEDICARE: MR. MICHAEL ANTHONY RAMOS P.A.-C, MPAS

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	363A00000X	Physician Assistant	NONE REQUIRED	NC

General Provider Information

NPI Number	:	1679566947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL ANTHONY RAMOS P.A.-C, MPAS

Provider Business Mailing Address
First Line	:	2729 PLUM RIDGE RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-7438
Country	:	US
Telephone Number	:	910-423-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	2729 PLUM RIDGE RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-7438
Country	:	US
Telephone Number	:	910-423-4326
Fax Number	:

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	09/14/2007

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