Provider Demographics
NPI:1407419336
Name:RAMAEKERS, DANIEL JOHN (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOHN
Last Name:RAMAEKERS
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 1:36108 N VIDLAK DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-5706
Mailing Address - Country:US
Mailing Address - Phone:602-200-4570
Mailing Address - Fax:
Practice Address - Street 1:36108 N VIDLAK DR
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-5706
Practice Address - Country:US
Practice Address - Phone:602-200-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8226363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant