Provider Demographics
NPI:1982675559
Name:DELGADO-RAMOS, IVAN (MD)
Entity type:Individual
Prefix:MR
First Name:IVAN
Middle Name:
Last Name:DELGADO-RAMOS
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 1:1500 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1935
Mailing Address - Country:US
Mailing Address - Phone:712-243-2606
Mailing Address - Fax:712-243-7811
Practice Address - Street 1:1500 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1935
Practice Address - Country:US
Practice Address - Phone:712-243-2606
Practice Address - Fax:712-243-7811
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA286092084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0093567Medicaid
IA0093567Medicaid
IA08917Medicare ID - Type Unspecified