Provider Demographics
NPI:1346545688
Name:ROCO, RAMON NEBRES (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:NEBRES
Last Name:ROCO
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 1:2799 ORCHARD TRAIL DR.
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4122
Mailing Address - Country:US
Mailing Address - Phone:248-642-3585
Mailing Address - Fax:
Practice Address - Street 1:2799 ORCHARD TRAIL DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-4122
Practice Address - Country:US
Practice Address - Phone:248-642-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033106208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice