Provider Demographics
NPI:1881952067
Name:RAMOS, TREVY (DO)
Entity type:Individual
Prefix:
First Name:TREVY
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E. 54TH AVE.
Mailing Address - Street 2:APT. 202A
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-545-2128
Mailing Address - Fax:
Practice Address - Street 1:325 N STATE OF FRANKLIN RD FL 3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6171
Practice Address - Country:US
Practice Address - Phone:423-439-7201
Practice Address - Fax:423-439-7219
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4091208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery