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Individual

PATRICK G RONAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1111 LEFFINGWELL AVE NE, STE 100, GRAND RAPIDS, MI 49525
(616) 459-7101
(616) 464-6170
Mailing address
1111 LEFFINGWELL AVE NE, STE 100, GRAND RAPIDS, MI 49525
(616) 459-7101
(616) 464-6170

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301073467
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
4301073467
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00228675
RR MEDICARE
Enumeration date
10/10/2005
Last updated
01/29/2013
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