Basic Information
| Provider Information | |||||||||
| NPI: | 1093166274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL SCANNING CONSULTANTS, P.A. | ||||||||
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| OtherOrganizationName: | RAYUS RADIOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5775 WAYZATA BLVD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | ST LOUIS PARK | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554161222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9525256338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3802 W INDUSTRIAL BLVD | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | BLOOMINGTON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 474035141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8123317727 | ||||||||
| FaxNumber: | 8123318983 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2016 | ||||||||
| LastUpdateDate: | 09/23/2021 | ||||||||
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| AuthorizedOfficialLastName: | BAKKER | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9525436504 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.