Provider Demographics
NPI:1790879575
Name:DE GUZMAN, RAMON R (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:R
Last Name:DE GUZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1450 NW 6035
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55485-6035
Mailing Address - Country:US
Mailing Address - Phone:952-542-8553
Mailing Address - Fax:952-513-6880
Practice Address - Street 1:166 19TH STREET SOUTH
Practice Address - Street 2:SUITE 100
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2154
Practice Address - Country:US
Practice Address - Phone:320-251-0609
Practice Address - Fax:320-251-3806
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.0885822085N0700X
MN516892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology