Individual
DR. RYAN M. FEDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2950 CURVE CREST BLVD W, STILLWATER, MN 55082
(651) 275-3000
(651) 275-3027
Mailing address
1719 TOWER DR W, STE 100, STILLWATER, MN 55082-7512
(651) 275-3000
(651) 275-3027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3016
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367199200
—
MN
Enumeration date
07/05/2006
Last updated
05/14/2020
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