Provider Demographics
NPI:1497048276
Name:RYSGAARD, CAROLYN DEE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:DEE
Last Name:RYSGAARD
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1406 6TH AVENUE NORTH
Mailing Address - Street 2:ST CLOUD PATHOLOGISTS PA
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1901
Mailing Address - Country:US
Mailing Address - Phone:320-255-5632
Mailing Address - Fax:320-255-5734
Practice Address - Street 1:1406 6TH AVENUE NORTH
Practice Address - Street 2:ST CLOUD PATHOLOGISTS PA
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1901
Practice Address - Country:US
Practice Address - Phone:320-255-5632
Practice Address - Fax:320-255-5734
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2017-05-09
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Provider Licenses
StateLicense IDTaxonomies
IAR-9174207ZP0102X
IAMD-42330207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology