Provider Demographics
NPI:1275625741
Name:RAMIREZ, SONIA ASIS (MD)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:ASIS
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:ASIS
Other - Last Name:RAMIREZ-JACOBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13355 E 10 MILE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-2048
Mailing Address - Country:US
Mailing Address - Phone:586-756-4086
Mailing Address - Fax:586-756-4088
Practice Address - Street 1:13355 E 10 MILE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-2048
Practice Address - Country:US
Practice Address - Phone:586-756-4086
Practice Address - Fax:586-756-4088
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISR032107207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2098972Medicaid
MI2098972Medicaid
MI0823954Medicare ID - Type Unspecified
MIP44050001Medicare PIN