Provider Demographics
NPI:1689775470
Name:POLITE, RONALD (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:POLITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14883
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-4883
Mailing Address - Country:US
Mailing Address - Phone:336-274-6515
Mailing Address - Fax:336-275-0812
Practice Address - Street 1:301 E WENDOVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1230
Practice Address - Country:US
Practice Address - Phone:336-274-3241
Practice Address - Fax:336-274-5021
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2002-01397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1326XOtherBCBS OF NC
NC802256OtherPARTNERS MEDICARE
NC891326XMedicaid
NCC0871OtherMEDCOST
NC2009636Medicare PIN
NC802256OtherPARTNERS MEDICARE
NC1326XOtherBCBS OF NC