Healthcare Provider Details

I. General information

NPI: 1740410653
Provider Name (Legal Business Name): RONALD R. CALDWELL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2009
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CHARLOTTE ST
ASHEVILLE NC
28801-1923
US

IV. Provider business mailing address

200 CHARLOTTE ST
ASHEVILLE NC
28801-1923
US

V. Phone/Fax

Practice location:
  • Phone: 828-258-9068
  • Fax: 828-253-7826
Mailing address:
  • Phone: 828-258-9068
  • Fax: 828-253-7826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20112
License Number StateNC

VIII. Authorized Official

Name: DR. RONALD RENORD CALDWELL
Title or Position: CEO
Credential: M.D.
Phone: 828-258-9068