Healthcare Provider Details

I. General information

NPI: 1083054084
Provider Name (Legal Business Name): RONALD L RAGLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 CHURCH ST NW # 608
WASHINGTON DC
20005-1912
US

IV. Provider business mailing address

1440 CHURCH ST NW # 608
WASHINGTON DC
20005-1912
US

V. Phone/Fax

Practice location:
  • Phone: 202-234-4864
  • Fax:
Mailing address:
  • Phone: 202-234-4864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberMD19854
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: