Provider Demographics
NPI:1699788059
Name:RATNER, EDWARD (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:RATNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8014 OLSON MEMORIAL HIGHWAY
Mailing Address - Street 2:#211
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4712
Mailing Address - Country:US
Mailing Address - Phone:612-384-9029
Mailing Address - Fax:
Practice Address - Street 1:8014 OLSON MEMORIAL HWY
Practice Address - Street 2:#211
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4712
Practice Address - Country:US
Practice Address - Phone:612-384-9029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31143207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN380000080Medicare ID - Type Unspecified
MNC42828Medicare UPIN