Provider Demographics
NPI:1871517169
Name:HARMENING, RONALD T (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:T
Last Name:HARMENING
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 1:1230 PENDLE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-9124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1230 PENDLE HILL AVE
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-9124
Practice Address - Country:US
Practice Address - Phone:765-778-2618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027067A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00074212OtherMEDICARE RAILROAD
IN100170950Medicaid
IN000000312822OtherANTHEM
INP00074212OtherMEDICARE RAILROAD
INB28434Medicare UPIN
INM400024596Medicare PIN