Provider Demographics
NPI:1740323435
Name:SPALTER, RONALD (OD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:SPALTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 W 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4236
Mailing Address - Country:US
Mailing Address - Phone:248-589-8580
Mailing Address - Fax:248-589-2349
Practice Address - Street 1:682 W 14 MILE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-4236
Practice Address - Country:US
Practice Address - Phone:248-589-8580
Practice Address - Fax:248-589-2349
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002830152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist