Healthcare Provider Details

I. General information

NPI: 1700712312
Provider Name (Legal Business Name): RONALD STREETMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E KEARSLEY ST
FLINT MI
48502-1950
US

IV. Provider business mailing address

303 E KEARSLEY ST
FLINT MI
48502-1950
US

V. Phone/Fax

Practice location:
  • Phone: 810-762-3420
  • Fax: 810-766-6851
Mailing address:
  • Phone: 810-762-3420
  • Fax: 810-766-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number1944619
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: