Provider Demographics
NPI:1043310071
Name:THOMAS D RAMAGE MD PA
Entity Type:Organization
Organization Name:THOMAS D RAMAGE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAMAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-623-2828
Mailing Address - Street 1:313 W COUNTRY CLUB RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5804
Mailing Address - Country:US
Mailing Address - Phone:505-623-2828
Mailing Address - Fax:
Practice Address - Street 1:313 W COUNTRY CLUB RD STE 3
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5804
Practice Address - Country:US
Practice Address - Phone:505-623-2828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM77-235207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM800521157Medicare Oscar/Certification