Healthcare Provider Details

I. General information

NPI: 1528472628
Provider Name (Legal Business Name): DARIN RUANPENG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 WOODWINDS DR
WOODBURY MN
55125-2298
US

IV. Provider business mailing address

1700 UNIVERSITY AVE W
SAINT PAUL MN
55104-3727
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-6800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number64664
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: