De Michaelis, Brian J

De Michaelis, Brian J is an individual health care provider with primary practice located at 3300 Oakdale Ave N , Robbinsdale MN 55422-2926. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. De Michaelis, Brian J can be contacted via phone (763) 559-2171.

Contact Information

Primary practice address
3300 Oakdale Ave N Robbinsdale MN 55422-2926
Phone: (763) 559-2171
Fax: (763) 694-9000
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 42494 Minnesota
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 42494 Minnesota
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X 42494 Minnesota
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 42494 Minnesota
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X 42494 Minnesota

Profile Details

NPI number 1891795928
LBN Legal business name De Michaelis, Brian J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Mar 3rd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891795928 NPPES
Minnesota MEDICAID 300405800

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