Individual
JORGE AUGUSTO RAMALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4700 KING ST STE 100, ALEXANDRIA, VA 22302-4420
(571) 665-6610
(571) 665-6611
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101272204
VA
207R00000X
Internal Medicine Physician
69618
WI
208000000X
Pediatrics Physician
0101272204
VA
208000000X
Pediatrics Physician
29618
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215354360
—
WI
Enumeration date
03/26/2014
Last updated
04/12/2022
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