Provider Demographics
NPI:1427166222
Name:RAMOS, MANUEL VILLAREAL JR (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:VILLAREAL
Last Name:RAMOS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1205 YORK RD
Mailing Address - Street 2:STE 36
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6210
Mailing Address - Country:US
Mailing Address - Phone:410-832-7350
Mailing Address - Fax:410-832-7351
Practice Address - Street 1:1205 YORK RD
Practice Address - Street 2:STE 36
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6210
Practice Address - Country:US
Practice Address - Phone:410-832-7350
Practice Address - Fax:410-832-7351
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD38950207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD552802000Medicaid
874L239EMedicare ID - Type Unspecified
E46630Medicare UPIN