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General NPI Number Information
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NPI Number | 1205632643
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Entity Type | Organization
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Legal Business Name | VASCULAR & INTERVENTIONAL PHYSICIANS
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 4254 QUEEN AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-1614
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Country | US
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Telephone | 612-743-9691
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Fax |
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Provider Business Mailing Address
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Address Line | 4254 QUEEN AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-1614
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Country | US
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Telephone | 612-743-9691
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MICHAEL JAMES CUMMING
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Credential | MD
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Telephone | 612-743-9691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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