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General NPI Number Information
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NPI Number | 1457330409
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Entity Type | Individual
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Provider Name | JEFFREY E MAGNUSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 7595 ANAGRAM DR
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-7399
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Country | US
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Telephone | 612-573-2200
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Fax | 612-573-2274
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Provider Business Mailing Address
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Address Line | 3570 RIDGEWOOD RD
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City | ARDEN HILLS
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State | MN
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Zip | 55112-3648
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Country | US
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Telephone | 651-336-1421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 30148
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License Number State | MN
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