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Individual

RIA EDWINA GRIPALDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 1ST ST SW, ROCHESTER, MN 55905
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34034
SC
207RP1001X
Pulmonary Disease Physician
34034
SC
207RP1001X
Pulmonary Disease Physician
63722
MN
207RP1001X
Pulmonary Disease Physician
Primary
83277
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340349
SC
01
AA79492603
MEDICARE PTAN
SC
Enumeration date
07/22/2008
Last updated
06/27/2019
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