Provider Demographics
NPI:1033641337
Name:MD ONLINE CARE P.C.
Entity Type:Organization
Organization Name:MD ONLINE CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:K
Authorized Official - Last Name:HER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-403-6673
Mailing Address - Street 1:7964 BROOKLYN BLVD # 140
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2722
Mailing Address - Country:US
Mailing Address - Phone:763-221-4189
Mailing Address - Fax:
Practice Address - Street 1:7964 BROOKLYN BLVD.
Practice Address - Street 2:SUITE 140
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2391
Practice Address - Country:US
Practice Address - Phone:763-221-4189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care