Individual
RYAN ROBERT FADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8100 W 78TH ST STE 225, EDINA, MN 55439-2569
(952) 946-9777
Mailing address
8100 W 78TH ST STE 225, EDINA, MN 55439-2569
(952) 946-9777
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
282757
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2011
Last updated
03/02/2021
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