Organization
REGIONAL DIAGNOSTIC RADIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E HONDL (BUSINESS MANAGER)
(320) 257-7794
Entity
Organization
Contact information
Practice address
1990 CONNECTICUT AVE S, SARTELL, MN 56377-2554
(320) 257-5595
(320) 257-5596
Mailing address
PO BOX 7366, SAINT CLOUD, MN 56302-7366
(320) 257-5595
(320) 257-5596
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55432CL
BLUE CROSS BLUE SHIELD
MN
05
—
775213000
—
MN
Enumeration date
01/03/2006
Last updated
09/15/2014
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