Provider Demographics
NPI:1780605550
Name:RAMIREZ, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:RAMIREZ
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 1:107 FIRST PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04937
Mailing Address - Country:US
Mailing Address - Phone:207-873-8100
Mailing Address - Fax:207-873-8101
Practice Address - Street 1:107 FIRST PARK DRIVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04937
Practice Address - Country:US
Practice Address - Phone:207-873-8100
Practice Address - Fax:207-873-8101
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012276207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME117870000Medicaid
000035OtherBX
ME433001499Medicaid
ME117870000Medicaid
000035OtherBX
D78786Medicare UPIN
MEMM074301Medicare PIN