Individual
RAYMOND JOHN POOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2085 RICE ST, ROSEVILLE, MN 55113-6807
(651) 489-9035
(651) 489-6373
Mailing address
6200 SHINGLE CREEK PKWY, SUITE 260, BROOKLYN CENTER, MN 55430-2128
(763) 561-5349
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
45375
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034201
PREFERRED ONE
MN
01
—
164081C028
UCARE
—
01
—
1835219
AMERICA'S PPO
MN
05
—
211914500
—
MN
01
—
3100162
MEDICA
MN
05
—
34354500
—
WI
01
—
428S0PO
BCBSMN
MN
01
—
HP37229
HEALTHPARTNERS
MN
Enumeration date
07/17/2006
Last updated
03/11/2021
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