Healthcare Provider Details

I. General information

NPI: 1013904655
Provider Name (Legal Business Name): ARNE VAINIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 TRETTEL LN
CLOQUET MN
55720-1345
US

IV. Provider business mailing address

927 TRETTEL LN
CLOQUET MN
55720-1345
US

V. Phone/Fax

Practice location:
  • Phone: 218-879-1227
  • Fax: 218-878-2136
Mailing address:
  • Phone: 218-879-1227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40356
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: