Provider Demographics
NPI:1275589632
Name:RAMIREZ, HENRY M (PA C)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:M
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15575 WELLS HWY
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1664
Mailing Address - Country:US
Mailing Address - Phone:864-886-2000
Mailing Address - Fax:864-888-3618
Practice Address - Street 1:15575 WELLS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678
Practice Address - Country:US
Practice Address - Phone:864-886-2000
Practice Address - Fax:864-888-3618
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC128363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q290421875Medicare ID - Type Unspecified
Q29042Medicare UPIN