Provider Demographics
NPI:1649957440
Name:ENDOVASCULAR PHYSICIANS OF MINNESOTA PLLC
Entity type:Organization
Organization Name:ENDOVASCULAR PHYSICIANS OF MINNESOTA PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEYED
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-960-9399
Mailing Address - Street 1:8401 GOLDEN VALLEY RD STE 340
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4488
Mailing Address - Country:US
Mailing Address - Phone:952-960-9399
Mailing Address - Fax:952-206-6467
Practice Address - Street 1:8401 GOLDEN VALLEY RD STE 340
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4488
Practice Address - Country:US
Practice Address - Phone:952-960-9399
Practice Address - Fax:952-206-6467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty