Basic Information
| Provider Information | |||||||||
| NPI: | 1487661336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REYNOLDS | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 DELAWARE ST SE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122736700 | ||||||||
| FaxNumber: | 6122768459 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 HARVARD ST SE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554550363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122733000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2006 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0203X | 37567 | MN | N | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology | 2085R0001X | 37567 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.