Provider Demographics
NPI:1912993064
Name:RINGEL, ROMAN ADAM (MD)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:ADAM
Last Name:RINGEL
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 1:3600 KOLBE RD
Mailing Address - Street 2:STE 222
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1654
Mailing Address - Country:US
Mailing Address - Phone:440-282-3128
Mailing Address - Fax:440-282-7503
Practice Address - Street 1:3600 KOLBE RD
Practice Address - Street 2:STE 222
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1654
Practice Address - Country:US
Practice Address - Phone:440-282-3128
Practice Address - Fax:440-282-7503
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350466032086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0546743Medicaid
OHH443022Medicare PIN
A80822Medicare UPIN
OH0776194Medicare PIN