Provider Demographics
NPI:1225029978
Name:ELG, RONALD L (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:ELG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22308207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
110898OtherUCARE
2114070OtherFIRST HEALTH PLAN
0429415OtherMEDICA HEALTH PLANS
986008OtherPREFERRED ONE
HP22736OtherHEALTH PARTNERS
600912OtherARAZ GROUP AMERICAS PPO
6D063ELOtherBLUE CROSS BLUE SHIELD
6D063ELOtherBLUE CROSS BLUE SHIELD
986008OtherPREFERRED ONE