Organization
CDI FAIRVIEW EDEN PRAIRIE LLC
Active
Other names
Center for Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D JACOBSEN (OFFICER ON THE BOARD SECRETARY)
(952) 543-6500
Entity
Organization
Contact information
Practice address
775 PRAIRIE CENTER DR, SUITE 260, EDEN PRAIRIE, MN 55344-7314
(952) 345-3805
(952) 294-8217
Mailing address
NW5765, PO BOX 1450, MINNEAPOLIS, MN 55485-5765
(952) 542-8553
(952) 513-6880
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
06/06/2006
Last updated
08/22/2020
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