Provider Demographics
NPI:1588850481
Name:GERALD F. RONNING MD PA
Entity Type:Organization
Organization Name:GERALD F. RONNING MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:RONNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1612-321-9757
Mailing Address - Street 1:527 MARQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-1302
Mailing Address - Country:US
Mailing Address - Phone:612-321-9757
Mailing Address - Fax:612-321-9013
Practice Address - Street 1:527 MARQUETTE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-1302
Practice Address - Country:US
Practice Address - Phone:612-321-9757
Practice Address - Fax:612-321-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16978261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health