Organization
MIDWEST RADIOLOGY, PA
Active
Other names
St. Paul Radiology, PA
Organization subpart
No
Provider details
NPI number
Authorized official
SEE YANG (CREDENTIALING MANAGER)
(651) 292-2013
Entity
Organization
Contact information
Practice address
2355 HWY 36 W., STE. 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-2000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
43
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435710800
—
MN
Enumeration date
06/22/2005
Last updated
05/26/2021
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