Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901019126 | MI |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 2901019126 | MI |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 4301097470 | MI |
N | 204E00000X | Oral & Maxillofacial Surgeon | ME112441 | FL |
NPI | 1023230927 |
---|---|
Provider Name | Carlos Antonio Ramirez-Neyra |
First Address | Troy, MI 48084-3935 |
Second Address | Warren, MI 48093-3491 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 03/03/2020 |