Provider Demographics
NPI:1336992874
Name:MEYER, RONALD WILLIAM (PA-C)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:WILLIAM
Last Name:MEYER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:RONNIE
Other - Middle Name:W
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1041 ROOSEVELT ST NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4541
Mailing Address - Country:US
Mailing Address - Phone:330-844-5708
Mailing Address - Fax:
Practice Address - Street 1:1041 ROOSEVELT ST NE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-4541
Practice Address - Country:US
Practice Address - Phone:330-844-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant