Provider Demographics
NPI:1629030952
Name:KELTER, RONALD A (PA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:A
Last Name:KELTER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:48 SANDERSON ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2778
Practice Address - Country:US
Practice Address - Phone:413-773-2655
Practice Address - Fax:413-773-2629
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant