Provider Demographics
NPI:1164408472
Name:RALSTON, DAVID R (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:R
Last Name:RALSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:745 WEST STATE ST
Mailing Address - Street 2:STE 510
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43222-1515
Mailing Address - Country:US
Mailing Address - Phone:614-464-0788
Mailing Address - Fax:614-464-0295
Practice Address - Street 1:5300 N MEADOWS DR STE 3800
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2546
Practice Address - Country:US
Practice Address - Phone:614-663-3877
Practice Address - Fax:614-663-3878
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2019-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35062009207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0984458Medicaid
OHF83377Medicare UPIN
OH0984458Medicaid