Provider Demographics
NPI:1134173339
Name:ABAZA, RONNEY (MD)
Entity type:Individual
Prefix:DR
First Name:RONNEY
Middle Name:
Last Name:ABAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RANEE
Other - Middle Name:
Other - Last Name:ABAZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2590
Practice Address - Country:US
Practice Address - Phone:147-962-9006
Practice Address - Fax:614-796-2901
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35087416208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2656719Medicaid
OHH194811OtherMEDICARE PIN