Provider Demographics
NPI:1043447139
Name:RONYAK, DANIELLE NICOLE (DPM)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:NICOLE
Last Name:RONYAK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27593 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1923
Mailing Address - Country:US
Mailing Address - Phone:586-779-6140
Mailing Address - Fax:586-779-9865
Practice Address - Street 1:27593 HARPER AVENUE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1923
Practice Address - Country:US
Practice Address - Phone:586-779-6140
Practice Address - Fax:586-779-9865
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002309213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist