MEDICARE: GERALD F. RONNING MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	16978	MN

General Provider Information

NPI Number	:	1588850481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERALD F. RONNING MD PA

Provider Business Mailing Address
First Line	:	527 MARQUETTE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-1302
Country	:	US
Telephone Number	:	612-321-9757
Fax Number	:	612-321-9013

Provider Business Practice Location Address
First Line	:	527 MARQUETTE AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-1302
Country	:	US
Telephone Number	:	612-321-9757
Fax Number	:	612-321-9013

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERALD FRANCIS RONNING
Credential	:
Telephone Number	:	16123219757

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	09/25/2007

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