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General NPI Number Information
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NPI Number | 1972540128
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Entity Type | Individual
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Provider Name | RONALD L SAGALOWSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 126 MIDDLE ST
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City | FARMINGTON
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State | ME
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Zip | 04938-6937
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Country | US
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Telephone | 207-778-4353
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Fax | 207-778-4238
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Provider Business Mailing Address
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Address Line | 126 MIDDLE ST
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City | FARMINGTON
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State | ME
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Zip | 04938-6937
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Country | US
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Telephone | 207-778-4353
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Fax | 207-778-4238
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | TD061040
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 01022328A
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License Number State | IN
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