Provider Demographics
NPI:1417965682
Name:BOYD, RONALD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:M
Last Name:BOYD
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 1:53 S PUUNENE AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2192
Mailing Address - Country:US
Mailing Address - Phone:808-877-6402
Mailing Address - Fax:808-871-5587
Practice Address - Street 1:53 S PUUNENE AVE STE 115
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2192
Practice Address - Country:US
Practice Address - Phone:808-877-6402
Practice Address - Fax:808-871-5587
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD109812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI563529Medicaid
HI100184Medicare ID - Type Unspecified
H100184Medicare PIN
HIH53125Medicare UPIN
HI563529Medicaid