Provider Demographics
NPI:1013970763
Name:RONAGHAN, CATHERINE ANN (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:RONAGHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 REYNOLDS ST STE 107
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6089
Mailing Address - Country:US
Mailing Address - Phone:912-819-7630
Mailing Address - Fax:912-819-5860
Practice Address - Street 1:5353 REYNOLDS ST STE 107
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6089
Practice Address - Country:US
Practice Address - Phone:912-819-7630
Practice Address - Fax:912-819-5860
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3602208600000X, 2086X0206X
GA908862086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003260714AMedicaid
TX084586901Medicaid
TX084586901Medicaid