Provider Demographics
NPI:1487758017
Name:ANGLADE, RONALD E (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:E
Last Name:ANGLADE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1930 BRANNAN RD
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4310
Mailing Address - Country:US
Mailing Address - Phone:678-284-4040
Mailing Address - Fax:678-284-4076
Practice Address - Street 1:1700 TREE LN STE 420
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6745
Practice Address - Country:US
Practice Address - Phone:770-979-9427
Practice Address - Fax:770-972-3846
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA052529208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00007657OtherRAILROAD MEDICARE
GAP00007657OtherRAILROAD MEDICARE
BA7859258OtherDEA
GA34BDDJRMedicare PIN