Individual
AMANDA BAILLARGEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7595 ANAGRAM DR, EDEN PRAIRIE, MN 55344-7399
(612) 573-2200
(612) 573-2274
Mailing address
7595 ANAGRAM DR, EDEN PRAIRIE, MN 55344-7399
(612) 573-2200
(612) 573-2274
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
59650
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2014
Last updated
07/12/2022
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