Provider Demographics
NPI:1184791485
Name:SROKA, RONALD C (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:SROKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1684 VILLAGE GREEN
Mailing Address - Street 2:CROFTON FAMILY PRACTICE
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114
Mailing Address - Country:US
Mailing Address - Phone:410-721-3822
Mailing Address - Fax:410-451-0960
Practice Address - Street 1:1684 VILLAGE GREEN
Practice Address - Street 2:CROFTON FAMILY PRACTICE
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114
Practice Address - Country:US
Practice Address - Phone:410-721-3822
Practice Address - Fax:410-451-0960
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0018480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8138RCOtherBLUE CROSS
DCF7860001OtherFEP BLUE CROSS
DCF7860001OtherFEP BLUE CROSS
B67323Medicare UPIN