Provider Demographics
NPI:1326106949
Name:RAMSDELL, BRUCE VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:VINCENT
Last Name:RAMSDELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 GODBY RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5012
Mailing Address - Country:US
Mailing Address - Phone:404-767-8274
Mailing Address - Fax:404-768-8035
Practice Address - Street 1:2225 GODBY RD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-5012
Practice Address - Country:US
Practice Address - Phone:404-767-8274
Practice Address - Fax:404-768-8035
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018722207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000158826DMedicaid
GA000158826DMedicaid