Provider Demographics
NPI:1104988393
Name:MEANS, RONALD (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:MEANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16361
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-0361
Mailing Address - Country:US
Mailing Address - Phone:410-752-0949
Mailing Address - Fax:410-752-0952
Practice Address - Street 1:920 SAINT PAUL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2423
Practice Address - Country:US
Practice Address - Phone:410-752-0949
Practice Address - Fax:410-752-0952
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00611022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405196300Medicaid
J097Medicare ID - Type Unspecified
I11028Medicare UPIN