Organization
MINNEAPOLIS RADIOLOGY ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA G NORBY (EXECUTIVE ASSISTANT/CREDENTIALING)
(763) 398-2203
Entity
Organization
Contact information
Practice address
3300 OAKDALE AVE N, ROBBINSDALE, MN 55422-2926
(763) 559-2171
(763) 694-9000
Mailing address
2955 XENIUM LN N, SUITE 40, PLYMOUTH, MN 55441-2666
(763) 398-2203
(763) 398-6533
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
173
MN
2085N0904X
Nuclear Radiology Physician
173
MN
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
173
MN
2085U0001X
Diagnostic Ultrasound Physician
173
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11634MI
BCBS
—
01
—
16-00010
MEDICA
—
05
—
724510600
—
MN
Enumeration date
08/09/2005
Last updated
11/04/2014
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