Provider Demographics
NPI:1316954191
Name:GREENWALD, RONALD S (MD)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:S
Last Name:GREENWALD
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 1:2500 HOSPITAL DR BLDG 15
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-968-4747
Mailing Address - Fax:650-968-8086
Practice Address - Street 1:2500 HOSPITAL DR BLDG 15
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-968-4747
Practice Address - Fax:650-968-8086
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56400207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G564000Medicare ID - Type Unspecified
CAE18344Medicare UPIN