Individual
DR. RONALD DETHOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
77 NELSON ST, SUITE 120, AUBURN, NY 13021-1944
(315) 252-7559
(315) 253-8104
Mailing address
77 NELSON ST, SUITE #120, AUBURN, NY 13021-1944
(315) 252-7559
(315) 253-8104
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
145322-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02023494
—
NY
Enumeration date
02/09/2007
Last updated
05/01/2015
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