Provider Demographics
NPI:1578548707
Name:MOTOS, RAMON AVIS (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:AVIS
Last Name:MOTOS
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:PO BOX CVPI
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-1100
Mailing Address - Country:US
Mailing Address - Phone:276-964-6771
Mailing Address - Fax:276-964-1321
Practice Address - Street 1:ONE CLINIC DR
Practice Address - Street 2:CLAYPOOL HILL
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-1100
Practice Address - Country:US
Practice Address - Phone:276-964-6771
Practice Address - Fax:276-964-1321
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101024963207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
005617731OtherRAILROAD MEDICARE
VA5617731Medicaid
240631OtherANTHEM BCBS
KY64005994Medicaid
WV0055887-000Medicaid
KY64005994Medicaid