Provider Demographics
NPI:1629203583
Name:TEMISTOCLES J. RAMIREZ, M.D., P.C.
Entity Type:Organization
Organization Name:TEMISTOCLES J. RAMIREZ, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TEMISTOCLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-434-2111
Mailing Address - Street 1:5333 MCAULEY DRIVE, SUITE 4112
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48106
Mailing Address - Country:US
Mailing Address - Phone:734-434-2111
Mailing Address - Fax:734-434-0905
Practice Address - Street 1:5333 MCAULEY DRIVE, SUITE 4112
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48106
Practice Address - Country:US
Practice Address - Phone:734-434-2111
Practice Address - Fax:734-434-0905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301042423103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0812016Medicaid
MIA73641Medicare UPIN