Individual
MIRIAM V RAGAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
110 OLSEN BLVD NE, COKATO, MN 55321-4359
(320) 286-2123
Mailing address
5001 AMERICAN BLVD W, STE 945, MINNEAPOLIS, MN 55437-1162
(952) 835-6653
(952) 835-3895
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
204656
NY
207Q00000X
Family Medicine Physician
Primary
54749
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00204656
—
NY
05
—
00307662
—
NY
01
—
331880
FQHC NUMBER
NY
Enumeration date
09/02/2005
Last updated
03/30/2023
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