Individual
RALPH E FEDOR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 255-5619
(320) 656-7068
Mailing address
PO BOX 7366, SAINT CLOUD, MN 56302-7366
(320) 255-5619
(320) 656-7068
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19700
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-29698
MEDICA
MN
01
—
26646
ARAZ/ AMERICA'S PPO
MN
01
—
54888FE
BLUE CROSS BLUE SHIELD
MN
01
—
965251008758
PREFERRED ONE
MN
01
—
HP25433
HEALTH PARTNERS
MN
Enumeration date
07/26/2005
Last updated
07/08/2007
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