Organization
NORTHLAKE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT RAMOS MD (PRESIDENT / OWNER)
(803) 622-3559
Entity
Organization
Contact information
Practice address
115 BLARNEY DR, SUITE 101 C, COLUMBIA, SC 29223-6291
(803) 419-5131
Mailing address
115 BLARNEY DR, SUITE 101 C, COLUMBIA, SC 29223-6291
(803) 419-5131
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
19001
SC
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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