Provider Demographics
NPI:1720035678
Name:RONALD D HOLGADO, DPM
Entity Type:Organization
Organization Name:RONALD D HOLGADO, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLGADO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:800-292-3008
Mailing Address - Street 1:52 WESTERVILLE SQ
Mailing Address - Street 2:SUITE 214
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2919
Mailing Address - Country:US
Mailing Address - Phone:800-292-3008
Mailing Address - Fax:330-629-9181
Practice Address - Street 1:52 WESTERVILLE SQ
Practice Address - Street 2:SUITE 214
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2919
Practice Address - Country:US
Practice Address - Phone:800-292-3008
Practice Address - Fax:330-629-9181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160941Medicaid
OHRO9305831Medicare ID - Type Unspecified