Provider Demographics
NPI:1821002197
Name:ARCEDO, VERNA C (DO)
Entity Type:Individual
Prefix:
First Name:VERNA
Middle Name:C
Last Name:ARCEDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11739
Mailing Address - Street 2:5001 NORTHWEST DR
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55111-0739
Mailing Address - Country:US
Mailing Address - Phone:773-339-6576
Mailing Address - Fax:
Practice Address - Street 1:5001 NORTHWEST DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55111-3033
Practice Address - Country:US
Practice Address - Phone:773-339-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102577207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine