Healthcare Provider Details

I. General information

NPI: 1699956391
Provider Name (Legal Business Name): RADIOLOGICAL ASSOCIATES OF DULUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E 37TH ST SUITE 30
HIBBING MN
55746-2971
US

IV. Provider business mailing address

1101 E 37TH ST SUITE 30
HIBBING MN
55746-2971
US

V. Phone/Fax

Practice location:
  • Phone: 218-312-1200
  • Fax: 218-312-1201
Mailing address:
  • Phone: 218-312-1200
  • Fax: 218-312-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANK J SUSLAVICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 218-722-3700