Provider Demographics
NPI:1700103033
Name:RAMIREZ, EDGAR RAYMUND DACLES (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR RAYMUND
Middle Name:DACLES
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAYMUND
Other - Middle Name:DACLES
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 LOTHROP ST # G100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-692-4882
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST # G100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-692-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD448929207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine