Provider Demographics
NPI:1366541856
Name:BENJAMIN S. RAMIREZ MD PC
Entity type:Organization
Organization Name:BENJAMIN S. RAMIREZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:SALAZAR
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-230-1288
Mailing Address - Street 1:1425 S GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3538
Mailing Address - Country:US
Mailing Address - Phone:810-230-1288
Mailing Address - Fax:810-230-1058
Practice Address - Street 1:1425 S GRAHAM RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3538
Practice Address - Country:US
Practice Address - Phone:810-230-1288
Practice Address - Fax:810-230-1058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301043485208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1001836OtherMCLAREN HEALTH PLAN
MI211938Medicaid
MIU09501OtherHEALTH ALLIANCE PLAN
MI666666OtherHEALTH PLUS
MIC4286OtherMCARE