Provider Demographics
NPI:1215960125
Name:RAMUS, STEVEN FREDERICK (PA-C)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:FREDERICK
Last Name:RAMUS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28800 RYAN RD STE 120
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-4269
Mailing Address - Country:US
Mailing Address - Phone:586-558-2860
Mailing Address - Fax:586-558-4624
Practice Address - Street 1:28800 RYAN RD STE 120
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-4269
Practice Address - Country:US
Practice Address - Phone:586-558-2860
Practice Address - Fax:586-558-4624
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004697363A00000X, 363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P03130Medicare ID - Type UnspecifiedCOMMON PROVIDER CODE