Provider Demographics
NPI:1679560213
Name:RAML, MATTHEW A (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:A
Last Name:RAML
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1664 PATTISON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-0617
Mailing Address - Country:US
Mailing Address - Phone:230-253-2038
Mailing Address - Fax:
Practice Address - Street 1:1500 IRVING ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2515
Practice Address - Country:US
Practice Address - Phone:320-491-6478
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1869204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine