Individual
RYAN M KROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Mailing address
49725 COUNTY 83, STAPLES, MN 56479-5280
(218) 894-1515
(218) 894-8767
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58091
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001-0117089
MEDICA
—
01
—
1235573049
BCBS
MN
05
—
1235573049
—
MN
Enumeration date
04/23/2013
Last updated
03/20/2017
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