Provider Demographics
NPI:1114162385
Name:ARNESON, MARCUS DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:DAVID
Last Name:ARNESON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2083 FORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1814
Mailing Address - Country:US
Mailing Address - Phone:651-698-1883
Mailing Address - Fax:
Practice Address - Street 1:2083 FORD PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1814
Practice Address - Country:US
Practice Address - Phone:651-698-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist