Provider Demographics
NPI:1881698363
Name:WARWAR, RONALD E (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:WARWAR
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 1:3100 GOVERNORS PLACE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1335
Mailing Address - Country:US
Mailing Address - Phone:937-297-7676
Mailing Address - Fax:937-297-7690
Practice Address - Street 1:3100 GOVERNORS PLACE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45409-1335
Practice Address - Country:US
Practice Address - Phone:937-297-7676
Practice Address - Fax:937-297-7690
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-9901-W207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0510790001OtherDMERC
OH0801326OtherUNITED HEALTHCARE
OH000000008972OtherANTHEM
OH310949280030OtherCARESOURCE
OH0285043Medicaid
OH0803251Medicare ID - Type Unspecified
OH0285043Medicaid