Provider Demographics
NPI:1336278316
Name:TASKA, RONALD (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:TASKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-1712
Mailing Address - Country:US
Mailing Address - Phone:252-792-5151
Mailing Address - Fax:252-792-0802
Practice Address - Street 1:210 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-1712
Practice Address - Country:US
Practice Address - Phone:252-792-5151
Practice Address - Fax:252-792-0802
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8981625Medicaid
NCA7189OtherMEDCOST