Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 60317 | MN |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD441949 | PA |
NPI | 1063671220 |
---|---|
Provider Name | Dr. Sofronio Cruz Ramirez JR. |
First Address | Bloomington, MN 55425-4516 |
Second Address | St Louis Park, MN 55416-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 11/03/2021 |