Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 54234 | MN |
Y | 207RP1001X | Pulmonary Disease | 54234 | MN |
NPI | 1003090358 |
---|---|
Provider Name | Dr. Ronald Alexander Reilkoff |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 17/08/2017 |