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Organization

ST PAUL RHEUMATOLOGY P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID J RIDLEY M.D. (OWNER)
(651) 644-4277
Entity
Organization

Contact information

Practice address
2854 HIGHWAY 55, SUITE 190, EAGAN, MN 55121-2156
(651) 644-4277
Mailing address
2854 HIGHWAY 55, SUITE 190, EAGAN, MN 55121-2156
(651) 644-4277

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
569199100
MN
Enumeration date
07/08/2006
Last updated
05/24/2021
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