Provider Demographics
NPI:1548243082
Name:RAMIREZ, RENATO P (MD)
Entity Type:Individual
Prefix:
First Name:RENATO
Middle Name:P
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:814-683-5661
Mailing Address - Fax:814-683-4120
Practice Address - Street 1:226 W ERIE ST
Practice Address - Street 2:
Practice Address - City:LINESVILLE
Practice Address - State:PA
Practice Address - Zip Code:16424-9214
Practice Address - Country:US
Practice Address - Phone:814-683-5661
Practice Address - Fax:814-683-4120
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019089E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026073740001Medicaid
PA066012RN0Medicare PIN
PAC28768Medicare UPIN