Provider Demographics
NPI:1699295568
Name:MELLO, RYAN N (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:N
Last Name:MELLO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6200 SHINGLE CREEK PKWY
Mailing Address - Street 2:STE 250
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2107
Mailing Address - Country:US
Mailing Address - Phone:763-544-0696
Mailing Address - Fax:763-544-0984
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:612-863-4000
Practice Address - Fax:763-236-3026
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
MN64430207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine