Provider Demographics
NPI:1689874018
Name:MOJICA, RONALD DIAL (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DIAL
Last Name:MOJICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 INDIAN QUEEN LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1520
Mailing Address - Country:US
Mailing Address - Phone:717-451-7211
Mailing Address - Fax:
Practice Address - Street 1:937 EAST HAVERFORD ROAD
Practice Address - Street 2:UNITED ANESTHESIA SERVICES
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-527-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT188023207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine