MEDICARE: DR. RAMON DARIO ESPINAL MD

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	208VP0014X	Interventional Pain Medicine Physician	052044	GA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	052044	GA

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
2	GRP7108	OTHER	GA	PROVIDER GROUP
3	1942486832	OTHER	GA	ORGANIZATION NPI

General Provider Information

NPI Number	:	1851390363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMON DARIO ESPINAL MD

Provider Business Mailing Address
First Line	:	3390 PEACHTREE RD NE STE 1500
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-2822
Country	:	US
Telephone Number	:	404-920-4950
Fax Number	:	404-920-4950

Provider Business Practice Location Address
First Line	:	5303 ADAMS ST NE
Second Line	:	STE C
City	:	COVINGTON
State	:	GA
Zip	:	30014-6208
Country	:	US
Telephone Number	:	678-729-8590
Fax Number	:	678-729-8595

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	05/03/2021

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