Provider Demographics
NPI:1538106950
Name:HENINGER, RONALD D (PA)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:HENINGER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4434
Mailing Address - Country:US
Mailing Address - Phone:828-258-8800
Mailing Address - Fax:828-258-0416
Practice Address - Street 1:129 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4434
Practice Address - Country:US
Practice Address - Phone:828-258-8800
Practice Address - Fax:828-258-0416
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103264363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S95517Medicare UPIN
NC2741411Medicare PIN
NC970020851Medicare PIN