Provider Demographics
NPI:1073691150
Name:RAMIREZ, PEDRO ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:ANTONIO
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:770-664-5660
Mailing Address - Fax:770-663-8672
Practice Address - Street 1:261 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004
Practice Address - Country:US
Practice Address - Phone:770-664-5660
Practice Address - Fax:770-663-8672
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA30365207Q00000X
NM85273207Q00000X
CT26397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BDBCHMedicare ID - Type Unspecified
E19615Medicare UPIN