Healthcare Provider Details

I. General information

NPI: 1649957440
Provider Name (Legal Business Name): ENDOVASCULAR PHYSICIANS OF MINNESOTA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 GOLDEN VALLEY RD STE 340
GOLDEN VALLEY MN
55427-4488
US

IV. Provider business mailing address

8401 GOLDEN VALLEY RD STE 340
GOLDEN VALLEY MN
55427-4488
US

V. Phone/Fax

Practice location:
  • Phone: 952-960-9399
  • Fax: 952-206-6467
Mailing address:
  • Phone: 952-960-9399
  • Fax: 952-206-6467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: SEYED ASTANI
Title or Position: OWNER
Credential: MD
Phone: 952-960-9399