Provider Demographics
NPI:1154332195
Name:FERRARA, ANTHONY B (MD)
Entity Type:Individual
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First Name:ANTHONY
Middle Name:B
Last Name:FERRARA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2025 SLOAN PL STE 35
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2092
Mailing Address - Country:US
Mailing Address - Phone:651-772-1572
Mailing Address - Fax:651-772-1889
Practice Address - Street 1:2980 BUCKLEY WAY
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-2017
Practice Address - Country:US
Practice Address - Phone:651-457-2748
Practice Address - Fax:651-457-0822
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2019-04-22
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Provider Licenses
StateLicense IDTaxonomies
MN24772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN651098100Medicaid
A95743Medicare UPIN