Provider Demographics
NPI:1801849468
Name:HOLGADO, RONALD D (DPM)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:D
Last Name:HOLGADO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15571 N REEMS RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-9584
Mailing Address - Country:US
Mailing Address - Phone:623-544-6932
Mailing Address - Fax:
Practice Address - Street 1:15571 N REEMS RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9584
Practice Address - Country:US
Practice Address - Phone:623-544-6932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002299H213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0632033Medicaid
OH0632033Medicaid
OHT80705Medicare UPIN