1669634242 NPI number — RAMON M SEVILLA M.D.

Table of content: RAMON M SEVILLA M.D. (NPI 1669634242)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669634242 NPI number — RAMON M SEVILLA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEVILLA
Provider First Name:
RAMON
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669634242
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 580
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIMA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45802-0580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-224-5707
Provider Business Mailing Address Fax Number:
419-223-2726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FINDLAY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45840-1214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-423-5429
Provider Business Practice Location Address Fax Number:
419-423-5297
Provider Enumeration Date:
06/25/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0204X , with the licence number:  35.124433 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0110602 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".