Provider Demographics
NPI:1316961865
Name:DEGARMO, RONALD G (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
Last Name:DEGARMO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MEMORIAL DRIVE EXTENSION
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651
Mailing Address - Country:US
Mailing Address - Phone:864-877-4442
Mailing Address - Fax:864-877-6080
Practice Address - Street 1:404 MEMORIAL DRIVE EXTENSION
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651
Practice Address - Country:US
Practice Address - Phone:864-877-4442
Practice Address - Fax:864-877-6080
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTL0326Medicaid
SCF493340281Medicare ID - Type Unspecified
SCTL0326Medicaid