Organization
HEALTHEAST MEDICAL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG DAVENPORT (CFO)
(651) 232-2250
Entity
Organization
Contact information
Practice address
3640 TALMAGE CIRCLE, STE 100, VADNAIS HEIGHTS, MN 55110
(651) 426-7226
(651) 426-7235
Mailing address
3640 TALMAGE CIRCLE, STE 100, VADNAIS HEIGHTS, MN 55110
(651) 426-7226
(651) 426-7235
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161668400
—
MN
Enumeration date
07/18/2006
Last updated
05/20/2015
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