Provider Demographics
NPI:1295834869
Name:RAMIREZ, BENJAMIN SALAZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SALAZAR
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 1:1425 S GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3538
Mailing Address - Country:US
Mailing Address - Phone:810-230-1288
Mailing Address - Fax:810-230-1058
Practice Address - Street 1:1425 S GRAHAM RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3538
Practice Address - Country:US
Practice Address - Phone:810-230-1288
Practice Address - Fax:810-230-1058
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043485208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI350250579OtherBC/BS OF MI
MI666666OtherHEALTH PLUS
MIC4286OtherMCARE
MI2119938Medicaid
MIU09501OtherHEALTH ALLIANCE PLAN
MI1001836OtherMCLAREN HEALTH PLAN