Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 40724 | MN |
N | 207XS0106X | Orthopaedic Hand Surgeon | 45423 | WI |
NPI | 1205832896 |
---|---|
Provider Name | Dr. Ryan Richard Karlstad |
First Address | Oak Park Heights, MN 55082-2177 |
Second Address | Oak Park Heights, MN 55082-2177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 30/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G76866 | (02) |