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Individual

DR. RONALD ROBIN MATHISEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5549 35TH ST NE, BUFFALO, MN 55313-3716
(763) 682-9052
(763) 782-8100
Mailing address
5549 35TH ST NE, BUFFALO, MN 55313-3716
(763) 682-9052
(763) 571-3008

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2147
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08F74MA
BCBS OF MN
MN
01
1000891
PREFERRED ONE
MN
01
107309
UCARE MN#
MN
01
2217160
MEDICA #
MN
01
23667
AMERICA'S PPO
MN
01
5439394
AETNA INS
MN
01
HP19896
HEALTHPARTNERS
MN
Enumeration date
07/02/2006
Last updated
07/09/2007
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