Doctor Name: | DR. RONALD G. BOOGAARD |
NPI Number: | 1275510356 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD031413E |
Business Practice Address: | 130 Northwest Dr Lebanon, PA - 170428915 |
Business Phone Number: | 7172745902 |
Business Fax Number: | |
Mailing Address: | 130 Northwest Dr, LEBANON |
State: | PA |
Postal Code: | 170428915 |
Phone Number: | 7172745902 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 08/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD031413E |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |