Individual
MR. KEITH MINTON RAMSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2490 CENTRAL AVE, LAKE STATION, IN 46405-2122
(219) 763-8112
(219) 962-1580
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5380
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01036485A
IN
207V00000X
Obstetrics & Gynecology Physician
036068254
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090423
BLUE CROSS BLUE SHIELD
IN
01
—
0090000637
BLUE CROSS BLUE SHIELD
IL
05
—
036068254
—
IL
05
—
100201350A
—
IN
01
—
M400041004
MEDICARE PTAN
IN
Enumeration date
01/09/2006
Last updated
07/31/2020
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