Provider Demographics
NPI:1740705243
Name:SUGRUE, RONAN PAUL (MD)
Entity type:Individual
Prefix:MR
First Name:RONAN
Middle Name:PAUL
Last Name:SUGRUE
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 1:75 FRANCIS STREET BRIGHAM AND WOMENS' HOSPITAL,
Mailing Address - Street 2:DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:774-208-2204
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS STREET BRIGHAM AND WOMENS' HOSPITAL
Practice Address - Street 2:DEPARTMENT OF OBSTETRICS AND GYNECOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:774-208-2204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2018-06-13
Deactivation Date:2018-03-14
Deactivation Code:
Reactivation Date:2018-06-13
Provider Licenses
StateLicense IDTaxonomies
MA270866207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology