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Individual

MIGUEL A RUIZ DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4730 CHICAGO AVE # MS 26602G, MINNEAPOLIS, MN 55407-3570
(952) 883-6805
(952) 853-8864
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
(952) 883-6805
(952) 853-8864

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38315
MN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
38315
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
517014100
MN
Enumeration date
02/01/2006
Last updated
12/30/2020
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