| Dr Tore Detlie, MD | |
|
918 Demont Ave E, Maplewood, MN 55109-1953 | |
| (952) 595-1100 | |
| (612) 294-4903 |
| Full Name | Dr Tore Detlie |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 41 Years |
| Location | 918 Demont Ave E, Maplewood, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841240686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 29546 (Minnesota) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | 15435 (New Hampshire) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Alomere Health | Alexandria, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medical Scanning Consultants Pa | 9032005376 | 81 |
| Medical Scanning Consultants Pa | 9032005376 | 81 |
| Medical Scanning Consultants Pa | 9032005376 | 81 |
| Entity Name | Medical Scanning Consultants Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659348092 PECOS PAC ID: 9032005376 Enrollment ID: O20040224001139 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tore Detlie, MD 11995 Singletree Ln, Suite 500, Eden Prairie, MN 55344-5347 Ph: (952) 595-1301 | Dr Tore Detlie, MD 918 Demont Ave E, Maplewood, MN 55109-1953 Ph: (952) 595-1100 |
Nicholas Basil Loudas, Radiology Medicare: Accepting Medicare Assignments Practice Location: 1575 Beam Ave, Maplewood, MN 55109 Phone: 651-232-7970 | |
Susan Yiquan Sun, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 1580 Beam Ave, Maplewood, MN 55109 Phone: 651-779-7978 Fax: 651-779-7656 | |
Warren A Mcguire, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 1580 Beam Ave, Maplewood, MN 55109 Phone: 651-779-7978 Fax: 651-779-7656 | |
Ellen E Bellairs, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1580 Beam Ave, Maplewood, MN 55109 Phone: 651-779-7978 Fax: 651-779-7656 |