Active NPI
Ronald E Fine, M.D., PH.D.
- Psychiatry Physician
- Traverse City, MI
National Provider Identifier
1871701151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301033894
- Practice address
- 107 E State St
Traverse City, MI 49684-2512 - Phone
- (231) 946-9613
- Fax
- (231) 946-9613
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301033894 | MI | Primary |
Addresses
Primary practice location
107 E State St
Traverse City, MI 49684-2512
Mailing address
107 E State St
Traverse City, MI 49684-2512
Phone (231) 946-9613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301033894 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871701151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 E STATE ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842512",
"telephone_number": "231-946-9613",
"fax_number": "231-946-9613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E STATE ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842512",
"telephone_number": "231-946-9613",
"fax_number": "231-946-9613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINE",
"first_name": "RONALD",
"middle_name": "E",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301033894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.