Provider Demographics
NPI:1801849831
Name:RAMIREZ, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3844 S LINDBERGH BLVD.
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-698-2400
Mailing Address - Fax:314-822-0975
Practice Address - Street 1:3844 S. LINDBERGH BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:ST .LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127
Practice Address - Country:US
Practice Address - Phone:314-698-2400
Practice Address - Fax:314-822-0975
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO36680207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202803615Medicaid
MO202803615Medicaid
E35347Medicare UPIN
MO004013422Medicare ID - Type Unspecified
IL0000705670Medicare NSC