Provider Demographics
NPI: | 1598769499 |
---|---|
Name: | RAMO, BARRY W (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | BARRY |
Middle Name: | W |
Last Name: | RAMO |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 502 ELM ST NE |
Mailing Address - Street 2: | |
Mailing Address - City: | ALBUQUERQUE |
Mailing Address - State: | NM |
Mailing Address - Zip Code: | 87102-2512 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 505-841-1000 |
Mailing Address - Fax: | 505-843-2956 |
Practice Address - Street 1: | 502 ELM ST NE |
Practice Address - Street 2: | |
Practice Address - City: | ALBUQUERQUE |
Practice Address - State: | NM |
Practice Address - Zip Code: | 87102-2512 |
Practice Address - Country: | US |
Practice Address - Phone: | 505-841-1000 |
Practice Address - Fax: | 505-843-2592 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-06-08 |
Last Update Date: | 2014-09-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NM | 72-215 | 207RC0000X, 207RC0001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NM | 26252 | Medicaid | |
D35899 | Medicare UPIN | ||
NM | 2134541 | Medicare PIN |