Individual
DR. RONALD WILSON MAKARUTSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
295 VARNUM AVE, LOWELL, MA 01854-2134
(978) 937-6000
Mailing address
9 MERRIMAC WAY UNIT H, TYNGSBORO, MA 01879-2760
(978) 853-0284
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
132742
MT
163W00000X
Registered Nurse
60919611
WA
163WG0100X
Gastroenterology Registered Nurse
266267
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
266267
MA
Other
Enumeration date
07/24/2019
Last updated
10/20/2022
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