Provider Demographics
NPI:1851333546
Name:EBB, RONALD G (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:EBB
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:50 MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453
Mailing Address - Country:US
Mailing Address - Phone:978-466-2280
Mailing Address - Fax:978-466-2282
Practice Address - Street 1:50 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 108
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453
Practice Address - Country:US
Practice Address - Phone:978-466-2280
Practice Address - Fax:978-466-2282
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2011-02-18
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Provider Licenses
StateLicense IDTaxonomies
MA212873208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
94135OtherFALLON
A3848701OtherMEDICARE
1287640OtherCIGNA
MA2110717Medicaid
1098412OtherAETNA
J29210OtherBLUE CROSS
478740OtherTUFTS
I38696Medicare UPIN
J29210OtherBLUE CROSS