Provider Demographics
NPI:1538431812
Name:LITVAK, RONALD (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:LITVAK
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 1:1195 CIRCLE ON THE GREEN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1208
Mailing Address - Country:US
Mailing Address - Phone:614-846-6518
Mailing Address - Fax:
Practice Address - Street 1:1195 CIRCLE ON THE GREEN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1208
Practice Address - Country:US
Practice Address - Phone:614-846-6518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3502747732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry