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1114081924
RONALD D DISTLER
ROSEDALE, MD
NPI
1114081924
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MD R136284)
Enumeration Date
2006-12-19
Last Update Date
2010-08-12
Business Address
Mr. RONALD D DISTLER CRNP
6918 RIDGE RD
ROSEDALE, MD 21237-3854
Phone number: 443-442-1568
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Mailing Address
Mr. RONALD D DISTLER CRNP
6918 RIDGE RD
ROSEDALE, MD 21237-3854
Phone number: 443-442-1568
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