Provider Demographics
NPI:1497700678
Name:RINGLE, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:RINGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 MEADOW BRIDGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6388
Mailing Address - Country:US
Mailing Address - Phone:937-208-7600
Mailing Address - Fax:937-208-7620
Practice Address - Street 1:1244 MEADOW BRIDGE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6388
Practice Address - Country:US
Practice Address - Phone:937-208-7600
Practice Address - Fax:937-208-7620
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-3187R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0676022Medicaid
OH0605195Medicare PIN
OH0676022Medicaid
A17111Medicare UPIN