Provider Demographics
NPI:1851390363
Name:ESPINAL, RAMON DARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:DARIO
Last Name:ESPINAL
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 1:3390 PEACHTREE RD NE STE 1500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-2822
Mailing Address - Country:US
Mailing Address - Phone:404-920-4950
Mailing Address - Fax:404-920-4950
Practice Address - Street 1:5303 ADAMS ST NE
Practice Address - Street 2:STE C
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-6208
Practice Address - Country:US
Practice Address - Phone:678-729-8590
Practice Address - Fax:678-729-8595
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052044208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000966501FMedicaid
GAGRP7108OtherPROVIDER GROUP
GA1942486832OtherORGANIZATION NPI
GA000966501FMedicaid
GA1942486832OtherORGANIZATION NPI