Individual
DR. RYAN JEREMY LAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-5362
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101021501
MI
207R00000X
Internal Medicine Physician
58.002509
OH
207RG0100X
Gastroenterology Physician
5101021501
MI
207RG0100X
Gastroenterology Physician
Primary
54485
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00998652
RAILROAD MEDICARE
MN
Enumeration date
04/16/2008
Last updated
09/30/2020
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