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Physicians Radiology Body Imaging

Provider NPI: 1912934498

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
Tel: 952-595-1100  Fax: 612-294-4903

Business Mailing Address:
Tel: 952-595-1301  Fax: 612-294-4903

NPI Information:
NPI: 1912934498
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Body Imaging

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 2085R0202X





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