Provider Demographics
NPI:1346283074
Name:RONAN, ARTHUR J (DO)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:J
Last Name:RONAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1881 W GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1840
Mailing Address - Country:US
Mailing Address - Phone:517-339-2116
Mailing Address - Fax:517-992-0399
Practice Address - Street 1:1881 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1840
Practice Address - Country:US
Practice Address - Phone:517-339-2116
Practice Address - Fax:517-999-2039
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013666207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003752OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI200000002629OtherPHP FAMILYCARE
MI4383330Medicaid
MI0M21440023OtherMEDICARE ADVANTAGE
MI200000002629OtherPHP
MI0853303075OtherBCBS/BCN
MI1003752OtherMCLAREN HEALTH ADVANTAGE
MI080182662OtherRAILROAD MEDICARE
MI1003752OtherMCLAREN HEALTH PLAN-MEDICAID
MI7874526OtherAETNA
MIH24028Medicare UPIN
MI7874526OtherAETNA