Provider Demographics
NPI:1609873447
Name:MENSH, RONALD S (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:S
Last Name:MENSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:340 MAIN ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1604
Mailing Address - Country:US
Mailing Address - Phone:508-754-3566
Mailing Address - Fax:508-798-8012
Practice Address - Street 1:140 HOSPITAL DRIVE
Practice Address - Street 2:MEDICAL BUILDING
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201
Practice Address - Country:US
Practice Address - Phone:802-447-1536
Practice Address - Fax:802-447-0996
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT0420006620207RG0100X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT5287Medicaid
VT5287Medicaid
VTVT5287Medicare ID - Type Unspecified