Provider Demographics
NPI:1609878032
Name:ENGEL, RONALD C (CRNA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:ENGEL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 OAK BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3222
Mailing Address - Country:US
Mailing Address - Phone:614-890-3131
Mailing Address - Fax:
Practice Address - Street 1:1198 OAK BLUFF CT
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3222
Practice Address - Country:US
Practice Address - Phone:614-890-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30845174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0785913Medicaid
OH000000121791OtherANTHEM BCBS
OH0785913Medicaid
OH000000121791OtherANTHEM BCBS