Provider Demographics
NPI:1194785279
Name:BOVARD, RALPH S (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:S
Last Name:BOVARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:205 WABASHA ST S
Mailing Address - Street 2:ATTN: RALPH BOVARD HEALTHPARTNERS
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-1805
Mailing Address - Country:US
Mailing Address - Phone:651-293-8100
Mailing Address - Fax:651-293-8106
Practice Address - Street 1:205 S WABASHA ST
Practice Address - Street 2:MAIL STOP 31300A HEALTHPARTNERS ST. PAUL CLINIC
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1805
Practice Address - Country:US
Practice Address - Phone:651-293-8100
Practice Address - Fax:651-293-8106
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-06-14
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Provider Licenses
StateLicense IDTaxonomies
MN293132083P0500X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN019275900Medicaid
E50035Medicare UPIN
MN019275900Medicaid