Provider Demographics
NPI:1093841678
Name:DEY, RANJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RANJAN
Middle Name:
Last Name:DEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 19TH ST S
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4654
Mailing Address - Country:US
Mailing Address - Phone:320-230-7788
Mailing Address - Fax:320-230-7789
Practice Address - Street 1:166 19TH ST S
Practice Address - Street 2:SUITE 101
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4654
Practice Address - Country:US
Practice Address - Phone:320-230-7788
Practice Address - Fax:320-230-7789
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56049207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H76514Medicare UPIN