Provider Demographics
NPI:1851385637
Name:MOLONY, RONALD R (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:R
Last Name:MOLONY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:MAIL CODE G5
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-4921
Mailing Address - Fax:
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:MAIL CODE B1
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2700
Practice Address - Fax:612-904-4440
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26003207RR0500X
MN50075207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B55190Medicare UPIN