Provider Demographics
NPI:1063633287
Name:AUGER, RONALD G (CERTIFIED PEDORTHIST)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:AUGER
Suffix:
Gender:M
Credentials:CERTIFIED PEDORTHIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 THOMPSON RD STE 4
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-1586
Mailing Address - Country:US
Mailing Address - Phone:508-461-7511
Mailing Address - Fax:860-546-1095
Practice Address - Street 1:336 THOMPSON RD STE 4
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1586
Practice Address - Country:US
Practice Address - Phone:508-461-7511
Practice Address - Fax:508-461-7515
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1510174400000X
224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004069993Medicaid