Individual
RAM PRASAD PANERU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 4TH ST NW, BAGLEY, MN 56621-8306
(218) 694-2384
(218) 694-6687
Mailing address
123 4TH ST NW, BAGLEY, MN 56621-8306
(218) 694-6501
(218) 694-6597
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
51422
MN
207Q00000X
Family Medicine Physician
12193
ND
207Q00000X
Family Medicine Physician
51422
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740457902
—
MN
01
—
P01201779
RR MEDICARE
MN
01
—
P01201785
RR MEDICARE
MN
01
—
P01204945
RR MEDICARE
MN
Enumeration date
05/15/2008
Last updated
10/10/2013
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