Provider Demographics
NPI:1366402786
Name:RAMOS, LIWLIWA QUITORIANO (MD)
Entity type:Individual
Prefix:MRS
First Name:LIWLIWA
Middle Name:QUITORIANO
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2025 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7827
Mailing Address - Country:US
Mailing Address - Phone:337-478-2573
Mailing Address - Fax:337-478-5296
Practice Address - Street 1:2770 3 AVE
Practice Address - Street 2:STE 225
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-418-2573
Practice Address - Fax:337-478-5296
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10997R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5W034Medicare ID - Type Unspecified
G01398Medicare UPIN