Provider Demographics
NPI:1942209309
Name:RAMOS CLINIC, PC
Entity type:Organization
Organization Name:RAMOS CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-583-4450
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND
Mailing Address - State:SD
Mailing Address - Zip Code:57059-0407
Mailing Address - Country:US
Mailing Address - Phone:605-583-4450
Mailing Address - Fax:605-583-4846
Practice Address - Street 1:1391 1ST ST
Practice Address - Street 2:
Practice Address - City:SCOTLAND
Practice Address - State:SD
Practice Address - Zip Code:57059-2040
Practice Address - Country:US
Practice Address - Phone:605-583-4450
Practice Address - Fax:605-583-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1052208600000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD21931OtherARAZ
SD7300030Medicaid
SD0000416OtherBLUE CROSS BLUE SHIELD
SD21931OtherARAZ
E15290Medicare UPIN