Provider Demographics
NPI:1508952615
Name:RAMIREZ, LORI K (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:K
Last Name:RAMIREZ
Suffix:
Gender:F
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:PO BOX 5546
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-5546
Mailing Address - Country:US
Mailing Address - Phone:801-475-3500
Mailing Address - Fax:801-475-3494
Practice Address - Street 1:1100 W 2700 N
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:UT
Practice Address - Zip Code:84404-4791
Practice Address - Country:US
Practice Address - Phone:801-475-3600
Practice Address - Fax:801-475-3601
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7704079-8017207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31179ZOtherGROUP ID NUMBER
CA00A699450Medicare ID - Type Unspecified
CAI20228Medicare UPIN