Provider Demographics
NPI:1689909343
Name:DE LA TORRE, RAMIRO ANTONIO PEREZ (MD)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:ANTONIO PEREZ
Last Name:DE LA TORRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3577 W 13 MILE RD
Mailing Address - Street 2:STE 206
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:877-784-3667
Mailing Address - Fax:248-869-3982
Practice Address - Street 1:3577 W 13 MILE RD
Practice Address - Street 2:STE 206
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:877-784-3667
Practice Address - Fax:248-869-3982
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073480207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery