Provider Demographics
NPI:1588718936
Name:SUAREZ-MARTINEZ, RAMON ALBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:ALBERTO
Last Name:SUAREZ-MARTINEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAMON
Other - Middle Name:ALBERTO
Other - Last Name:SUAREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:320 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1411
Mailing Address - Country:US
Mailing Address - Phone:978-655-5290
Mailing Address - Fax:978-655-4525
Practice Address - Street 1:320 ESSEX ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1411
Practice Address - Country:US
Practice Address - Phone:978-655-5290
Practice Address - Fax:978-655-4525
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1588718936Medicare UPIN
MA001689401Medicare PIN
PR009279Medicare ID - Type Unspecified
PRD26751Medicare UPIN