Provider Demographics
NPI:1629409123
Name:RONALD MAGAT MD, LLC
Entity Type:Organization
Organization Name:RONALD MAGAT MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-680-3972
Mailing Address - Street 1:4205 HASTINGS DRIVE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:770-406-8959
Mailing Address - Fax:
Practice Address - Street 1:3830 WINDERMERE PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6160
Practice Address - Country:US
Practice Address - Phone:678-680-3972
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2014-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0518302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty