Provider Demographics
NPI:1316039936
Name:PACIS, RONALD ARNOLD (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ARNOLD
Last Name:PACIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1540 LAKE LANSING RD
Mailing Address - Street 2:SUITE G02
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3756
Mailing Address - Country:US
Mailing Address - Phone:517-913-6650
Mailing Address - Fax:517-913-6677
Practice Address - Street 1:1540 LAKE LANSING RD
Practice Address - Street 2:SUITE G02
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3756
Practice Address - Country:US
Practice Address - Phone:517-913-6650
Practice Address - Fax:517-913-6677
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015144207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0653312085OtherBCBS
MI7330885OtherAETNA
MIP00399163OtherRAILROAD MEDICARE
MI0M21440060OtherMEDICARE ADVANTAGE
MI200000009181OtherPHP
MI200000009181OtherPHP FAMILYCARE
MI1027854OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1027854OtherMCLAREN HEALTH PLAN-MEDICAID
MI4989908Medicaid
1027854OtherMCLAREN HEALTH ADVANTAGE
MI9467710OtherPHCS
MIM21440060Medicare PIN