MEDICARE: DR. RONALD PURCELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME96892	FL
2	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	ME96892	FL

General Provider Information

NPI Number	:	1437358801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD PURCELL M.D.

Provider Business Mailing Address
First Line	:	2550 SOM CENTER RD # WH20
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9655
Country	:	US
Telephone Number	:	440-516-8393
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 SOM CENTER RD STE 310
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9655
Country	:	US
Telephone Number	:	440-516-8393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	02/13/2018

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