Provider Demographics
NPI:1992772354
Name:PERRY RAMIREZ, DANIELLE R (MD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:R
Last Name:PERRY RAMIREZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4422 WHITE BEAR AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-287-8780
Mailing Address - Fax:651-287-8786
Practice Address - Street 1:4422 WHITE BEAR AVE
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110
Practice Address - Country:US
Practice Address - Phone:651-287-8780
Practice Address - Fax:651-287-8786
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2024-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN44798207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN702625100Medicaid
MN702625100Medicaid
H71914Medicare UPIN