Individual
MR. RONALD BATHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
80 PINNACLES DR, BUILDING B, SUITE 700, PALM COAST, FL 32164-2323
(386) 586-2234
(386) 586-2884
Mailing address
PO BOX 35-2077, PALM COAST, FL 32135-2077
(386) 586-2234
(386) 586-2884
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME0046366
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156214BAT
UHC
—
01
—
5873158
AETNA
—
Enumeration date
08/22/2006
Last updated
06/24/2010
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