Healthcare Provider Details
I. General information
NPI: 1265404057
Provider Name (Legal Business Name): RAMALINGAM ARUMUGAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/06/2006
Last Update Date: 05/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 UNIVERSITY AVE W SUITE 120
SAINT PAUL MN
55114-1920
US
IV. Provider business mailing address
PO BOX 14909
MINNEAPOLIS MN
55414-0909
US
V. Phone/Fax
- Phone: 612-871-1145
- Fax: 612-870-5491
- Phone: 612-871-1145
- Fax: 612-870-5491
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 41440 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: