Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 55047 | MN |
Y | 208600000X | Surgeon | 55047 | MN |
N | 2086S0102X | Surgical Critical Care | 55047 | MN |
NPI | 1093033813 |
---|---|
Provider Name | Dr. Ryan Flegenheimer Deisler |
First Address | Minneapolis, MN 55401-1584 |
Second Address | Minneapolis, MN 55415-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2010 |
Last Update Date | 14/04/2020 |