Provider Demographics
NPI:1134106313
Name:SEVILLA, RAMON ZIALCITA (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ZIALCITA
Last Name:SEVILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 REGENCY CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3090
Mailing Address - Country:US
Mailing Address - Phone:419-720-7590
Mailing Address - Fax:419-720-7592
Practice Address - Street 1:2000 REGENCY CT
Practice Address - Street 2:SUITE 200
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3090
Practice Address - Country:US
Practice Address - Phone:419-720-7590
Practice Address - Fax:419-720-7592
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH038617208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0304414Medicaid
OHA75521Medicare UPIN
OHSE0419632Medicare ID - Type Unspecified