Provider Demographics
NPI:1427673136
Name:RONALD BUGAOAN MD LLC
Entity type:Organization
Organization Name:RONALD BUGAOAN MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUGAOAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-817-2833
Mailing Address - Street 1:225 WATER ST STE A140
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-6248
Mailing Address - Country:US
Mailing Address - Phone:617-817-2833
Mailing Address - Fax:781-987-9286
Practice Address - Street 1:225 WATER ST STE A140
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-6248
Practice Address - Country:US
Practice Address - Phone:617-817-2833
Practice Address - Fax:781-987-9286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty