Provider Demographics
NPI:1538350962
Name:MCELLISTREM-RAMIEREZ, MEGAN LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LYNN
Last Name:MCELLISTREM-RAMIEREZ
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2945 HAZELWOOD ST
Mailing Address - Street 2:STE 210
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1241
Mailing Address - Country:US
Mailing Address - Phone:651-770-3320
Mailing Address - Fax:
Practice Address - Street 1:1737 BEAM AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-2185
Practice Address - Country:US
Practice Address - Phone:651-770-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2020-09-08
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Provider Licenses
StateLicense IDTaxonomies
MN17837207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology