Provider Demographics
NPI:1629053368
Name:ZEGERIUS, RONALD JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAMES
Last Name:ZEGERIUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M230
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-345-9606
Mailing Address - Fax:269-373-7095
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M230
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-345-9606
Practice Address - Fax:269-373-7095
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301034102207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3520425Medicaid
MIB45562Medicare UPIN