Provider Demographics
NPI:1649593161
Name:CARDIOVASCULAR IMAGING CONSULTANTS, LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR IMAGING CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLODAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-929-5600
Mailing Address - Street 1:7801 E BUSH LAKE RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3120
Mailing Address - Country:US
Mailing Address - Phone:952-831-5773
Mailing Address - Fax:952-831-7224
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:SUITE 125
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2131
Practice Address - Country:US
Practice Address - Phone:952-929-5600
Practice Address - Fax:952-929-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty