Mall, Ronald Martin

Mall, Ronald Martin is an individual health care provider with primary practice located at 3800 East Bay Drive East Bay Medical Center, Largo FL 33771. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Mall, Ronald Martin can be contacted via phone (727) 539-0505.

Contact Information

Primary practice address
3800 East Bay Drive East Bay Medical Center Largo FL 33771
Phone: (727) 539-0505
Fax: (727) 394-1804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X OS0003675 Florida

Profile Details

NPI number 1083648703
LBN Legal business name Mall, Ronald Martin
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Dec 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083648703 NPPES
Other 2337655 AETNA
Other 267070 AETNA

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