Provider Demographics
NPI:1194601542
Name:INGE, RONNELL EUGENE
Entity type:Individual
Prefix:
First Name:RONNELL
Middle Name:EUGENE
Last Name:INGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2542
Mailing Address - Country:US
Mailing Address - Phone:216-800-2353
Mailing Address - Fax:
Practice Address - Street 1:10505 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-2542
Practice Address - Country:US
Practice Address - Phone:216-800-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant