Provider Demographics
NPI:1568430650
Name:DIGBY, RONALD WYMAN (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:WYMAN
Last Name:DIGBY
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 1:660 SUMMIT CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2181
Mailing Address - Country:US
Mailing Address - Phone:704-867-0735
Mailing Address - Fax:704-867-0738
Practice Address - Street 1:660 SUMMIT CROSSING PL
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2104
Practice Address - Country:US
Practice Address - Phone:704-867-0735
Practice Address - Fax:704-867-0738
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21642207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8928580Medicaid
NC8928580Medicaid
C87753Medicare UPIN