Provider Demographics
NPI:1760554737
Name:RAMOS, ANTONIO D (MD)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:D
Last Name:RAMOS
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 1:1022 GULICK AVENUE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4511
Mailing Address - Country:US
Mailing Address - Phone:808-847-4659
Mailing Address - Fax:808-845-9338
Practice Address - Street 1:1022 GULICK AVENUE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4511
Practice Address - Country:US
Practice Address - Phone:808-847-4659
Practice Address - Fax:808-845-9338
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5242207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI01899601Medicaid
HI192100101OtherHMA
HI00C0020382OtherHMSA
HI01899601Medicaid
D36414Medicare UPIN