| Raydiant Wellness Llc | |
|
275 37th St Ne Ste 500 Rochester MN 55906-5464 | |
| (507) 242-8746 | |
| (507) 204-2117 |
| Full Name | Raydiant Wellness Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 275 37th St Ne Ste 500, Rochester, Minnesota |
| Authorized Official Name and Position | Malia Ray (PHYSICIAN/OWNER) |
| Authorized Official Contact | 5135151727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raydiant Wellness Llc 6674 Zumbro Hylands Nw Rochester MN 55901-8516 Ph: (513) 515-1727 | Raydiant Wellness Llc 275 37th St Ne Ste 500 Rochester MN 55906-5464 Ph: (507) 242-8746 |
| NPI Number | 1710511621 |
|---|---|
| Provider Enumeration Date | 02/29/2020 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 3375960743 |
|---|---|
| Medicare Enrollment ID | O20200831001386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710511621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Malia Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942418447 PECOS PAC ID: 2769647932 Enrollment ID: I20150731015606 |
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