MEDICARE: DR. RONALD M UNICE D.O.

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	207Q00000X	Family Medicine Physician	OS-005951-L	PA
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	OS005951L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083685879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD M UNICE D.O.

Provider Business Mailing Address
First Line	:	765 LIBERTY ST
Second Line	:	SUITE 109
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2566
Country	:	US
Telephone Number	:	814-337-5373
Fax Number	:	814-337-3229

Provider Business Practice Location Address
First Line	:	765 LIBERTY ST
Second Line	:	SUITE 109
City	:	MEADVILLE
State	:	PA
Zip	:	16335-2566
Country	:	US
Telephone Number	:	814-337-5373
Fax Number	:	814-337-3229

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

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	03/17/2021

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