Ryan B Fuder, PHARMD.

Primary specialty

PharmacistTaxonomy code 183500000X

License

118575 Issued in MN

Practice address

11330 Fountains Drive N
Maple Grove, MN 55369-1304

Phone

(763) 494-8059

NPI assigned

Nov 18, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Maplewood, MN
  • NPI 1457533143
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1144597170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 ASPEN LAKE DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493100",
            "telephone_number": "763-792-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 FOUNTAINS DRIVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553691304",
            "telephone_number": "763-494-8059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUDER",
        "first_name": "RYAN",
        "middle_name": "B",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-18",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "118575",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Frisch
• Edward Jon Froehlich, LICSW
• Katie Jo Frokjer, DPT
• Elizabeth Anne Fronek, MD
• Fu Wong DDS PA
• Margaret Funk, M.D.
• G.R. Thomas Jr OD PA
• Taylor Gaikowski, RDN, LD
• Michael A Gallagher, FNP
• Kathleen M Hill Gallant, PHD, RD

• Pharmacist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.