Individual
DR. RONALD G. BOOGAARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 NORTHWEST DR, LEBANON, PA 17042-8915
(717) 274-5902
Mailing address
130 NORTHWEST DR, LEBANON, PA 17042-8915
(717) 274-5902
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD031413E
PA
207RC0000X
Cardiovascular Disease Physician
Primary
MD031413E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018856010004
—
PA
Enumeration date
12/29/2005
Last updated
08/12/2015
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