Provider Demographics
NPI:1568481109
Name:MCGLENNEN, RONALD C (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:MCGLENNEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7400 FLYING CLOUD DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3720
Mailing Address - Country:US
Mailing Address - Phone:952-942-0671
Mailing Address - Fax:
Practice Address - Street 1:7400 FLYING CLOUD DR
Practice Address - Street 2:SUITE 150
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3720
Practice Address - Country:US
Practice Address - Phone:952-942-0671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN31318170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics