Organization
MAPLEWOOD IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEE YANG (CREDENTIALING MANAGER)
(651) 292-2013
Entity
Organization
Contact information
Practice address
2945 HAZELWOOD ST STE 110, MAPLEWOOD, MN 55109-1242
(651) 292-2000
(651) 292-2136
Mailing address
2355 HWY 36 W., STE. 100, ROSEVILLE, MN 55113
(651) 292-2000
(651) 681-1140
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037988000
—
MN
Enumeration date
11/30/2007
Last updated
02/02/2022
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