Individual
DR. LAURENCE J RONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 PARKMAN ST, WAC 605 INTERNAL MEDICINE ASSOCIATES TEAM 2, BOSTON, MA 02114-3117
(617) 726-7930
(617) 724-0331
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-1980
(617) 726-1985
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
72946
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072946
TUFTS HEALTH PLAN
MA
05
—
3092020
—
MA
01
—
J12306
BCBS MA
MA
Enumeration date
10/25/2005
Last updated
07/23/2012
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