DR. RONALD WILLIAM LUETHKE (NPI# 1376518704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376518704 |
| Entity Type | Individual |
| Full Name | DR. RONALD WILLIAM LUETHKE |
| Credential | M.D. |
| Practice Address |
527 Medical Park Dr Ste 203 Bridgeport WV 26330-9009 |
| Mailing Address |
527 Medical Park Dr Ste 400 Bridgeport WV 26330-9010 |
| Practice Telephone | 6813423190 |
| Practice Fax Number | 6813423195 |
| Mailing Telephone | 6813423190 |
| Mailing Fax Number | 6813423195 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | D36862 | MD | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
25755 | WV | Allopathic & Osteopathic Physicians |
| N | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
D36862 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 531561100 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10710 Charter Dr, Suite 240, Columbia, MD 210443128 | 4109648287 | 4109642761 |
| Street Address |
527 MEDICAL PARK DR STE 203 |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-9009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306267646 | United Hospital Center | Plastic Surgery | 527 Medical Park Dr Ste 203, Bridgeport, WV 26330-9009 | 2014-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346365418 | William Aaron Ross | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-03-20 |
| 1407893035 | Paul D Edwards | Surgery | 2561 Third Avenue, Pediatric Plastic Surgery/craniofacial C, Huntington, WV 02570 | 2006-06-01 |
| 1477505956 | Peter Damian Ray | Surgery | 5185 Us Rt 60 East, Suite 26, Huntington, WV 25705 | 2006-05-16 |
| 1811980113 | Abdalla Zackaria Bandak | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2005-08-23 |
| 1407343601 | Skyline Wound Care Pllc | Surgery | 80 Maddex Dr, Shepherdstown, WV 25443-4305 | 2018-04-13 |
| 1336328467 | John David Hayes | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-10-25 |
| 1457564213 | Bandak Plastic Surgery Pllc | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2007-05-08 |
| 1902929219 | Phillip Limbaugh Lackey | Surgery | 1540 Spring Valley Dr, Huntington, WV 25704-9501 | 2007-04-10 |
| 1891780755 | Karl J Mueller | Surgery | 40 Medical Park, Suite 200, Wheeling, WV 26003-6392 | 2005-09-16 |
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on DR. RONALD WILLIAM LUETHKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.