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Individual

DR. RONALD MAXWELL MASTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1675 PHOENIX ST STE 9, SOUTH HAVEN, MI 49090-8658
(269) 639-2545
(269) 639-2137
Mailing address
1675 PHOENIX ST STE 9, SOUTH HAVEN, MI 49090-8658
(269) 639-2545
(269) 639-2137

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038012165
IL
111N00000X
Chiropractor
Primary
2301009746
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0044472879
MI
01
950A310570
BCBSM
MI
01
G06732
BCN
MI
Enumeration date
01/31/2011
Last updated
09/16/2015
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