Provider Demographics
NPI:1467166116
Name:LLULL CERDA, RAMON (MD, PHD)
Entity Type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:LLULL CERDA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:RAMON
Other - Middle Name:
Other - Last Name:LLULL CERDA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:100 KIMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6074
Mailing Address - Country:US
Mailing Address - Phone:336-716-0238
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-4171
Practice Address - Fax:336-716-8759
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-02760208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery