Provider Demographics
NPI:1245307610
Name:STRICKLER, RONALD C (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:STRICKLER
Suffix:
Gender:M
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:HENRY FORD HEALTH SYSTEM
Mailing Address - Street 2:3031 WEST GRAND BLVD.
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-4445
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD HEALTH SYSTEM
Practice Address - Street 2:3031 WEST GRAND BLVD.
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-916-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI069333207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI333287310Medicaid
700H262210OtherBLUE CROSS-BLUE CROSS
RS069333OtherCHAMPUS-CHAMPUS
RS069333OtherCOMMERCIAL-COMMERCIAL NUMBER
RS069333OtherCHAMPUS-CHAMPUS
RS069333OtherCOMMERCIAL-COMMERCIAL NUMBER