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Individual

DR. SHAWN M. RONAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-1000
Mailing address
8170 33RD AVE S, MS21110Q, BLOOMINGTON, MN 55425-4516
(952) 883-6412

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2007-00903
NC
207W00000X
Ophthalmology Physician
4301082323
MI
207W00000X
Ophthalmology Physician
54273
WI
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
61616
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5907098
NC
Enumeration date
03/27/2007
Last updated
05/29/2019
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