Individual
RONALD W DIVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3501 N SCOTTSDALE RD STE 130, SCOTTSDALE, AZ 85251-5649
(480) 425-5000
Mailing address
PO BOX 2156, CORVALLIS, OR 97339-2156
(541) 758-5047
(541) 758-3713
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
21536
OR
2085R0202X
Diagnostic Radiology Physician
Primary
36719
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102232
—
AZ
05
—
138138
—
OR
Enumeration date
05/04/2006
Last updated
02/18/2019
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