Provider Demographics
NPI:1083855563
Name:MUNN, RONALD SCOTT (CCP, RN)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:SCOTT
Last Name:MUNN
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Gender:M
Credentials:CCP, RN
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Mailing Address - Street 1:2200 PHILADELPHIA DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1840
Mailing Address - Country:US
Mailing Address - Phone:937-279-9777
Mailing Address - Fax:937-279-9332
Practice Address - Street 1:2200 PHILADELPHIA DR
Practice Address - Street 2:SUITE 301
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1840
Practice Address - Country:US
Practice Address - Phone:937-279-9777
Practice Address - Fax:937-279-9332
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN-197689163W00000X
242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist
No163W00000XNursing Service ProvidersRegistered Nurse