Basic Information
| Provider Information | |||||||||
| NPI: | 1811919426 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL SCANNING CONSULTANTS PA | ||||||||
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| OtherOrganizationName: | RAYUS RADIOLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 856702 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554856700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666747933 | ||||||||
| FaxNumber: | 9525136880 | ||||||||
| Practice Location | |||||||||
| Address1: | 2445 NORTH MAYFAIR ROAD | ||||||||
| Address2: | |||||||||
| City: | WAUWASTOSA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4147747226 | ||||||||
| FaxNumber: | 4147746004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAKKER | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICER (CFO) | ||||||||
| AuthorizedOfficialTelephone: | 9525436504 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/25/2022 | ||||||||
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.