Provider Demographics
NPI:1184799918
Name:RAMOS, MARCO A (MD)
Entity type:Individual
Prefix:DR
First Name:MARCO
Middle Name:A
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 1:4 COLUMBUS AVE
Mailing Address - Street 2:STE 240
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6472
Mailing Address - Country:US
Mailing Address - Phone:888-569-4010
Mailing Address - Fax:989-509-5967
Practice Address - Street 1:2210 NEIDHAMMER DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-9497
Practice Address - Country:US
Practice Address - Phone:888-569-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMRO77734207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00330128OtherGRP DE9866 RAILROAD MEDIC
MI1417961137OtherBCBSM - BMH
MI1235131137OtherBCBSM - BLH
MI4860744Medicaid
MI1106510651OtherBLUE CROSS BLUE SHIELD MI
MI4857435Medicaid
MI1184799918Medicaid
MI4860280Medicaid
MIP00330128OtherGRP DE9866 RAILROAD MEDIC
MI4860744Medicaid
MI1417961137OtherBCBSM - BMH
MIC97618348 - BMHMedicare PIN