Provider Demographics
NPI:1427097070
Name:BATEMAN, RONALD M (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:M
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3915 GOLDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4249
Mailing Address - Country:US
Mailing Address - Phone:763-520-0454
Mailing Address - Fax:763-520-0727
Practice Address - Street 1:3915 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4249
Practice Address - Country:US
Practice Address - Phone:763-520-0454
Practice Address - Fax:763-520-0727
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22770225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN101451OtherUCARE PROV#
MN971840581001OtherPREFERRED ONE PROV#
MN01008BAOtherBCBS OF MN GR#
MN2303831OtherMEDICA
MN971840581001OtherPREFERRED ONE PROV#
MN2303831OtherMEDICA