Provider Demographics
NPI:1356559983
Name:RTGMEDICAL
Entity type:Organization
Organization Name:RTGMEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRAVEL SONOGRAPHER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:DONER
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:802-282-2101
Mailing Address - Street 1:2186 BANEBERRY WAY W
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317
Mailing Address - Country:US
Mailing Address - Phone:802-282-2101
Mailing Address - Fax:
Practice Address - Street 1:2186 BANEBERRY WAY W
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317
Practice Address - Country:US
Practice Address - Phone:802-282-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital