Provider Demographics
NPI:1225098387
Name:RAMOS, ARLENE GACUTAN (MD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:GACUTAN
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-475-7163
Mailing Address - Fax:336-475-1199
Practice Address - Street 1:903 RANDOLPH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5898
Practice Address - Country:US
Practice Address - Phone:336-475-7163
Practice Address - Fax:336-475-1199
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9901297208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891218QMedicaid
NC2278128DMedicare PIN
NC891218QMedicaid
NC2278128EMedicare PIN
G89610Medicare UPIN