Provider Demographics
NPI:1972867810
Name:ARNEVIK, RYAN D (DO)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:D
Last Name:ARNEVIK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:19942 SAINT JOSEPH DRIVE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-8849
Mailing Address - Country:US
Mailing Address - Phone:641-856-8684
Mailing Address - Fax:641-856-3009
Practice Address - Street 1:19942 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-8849
Practice Address - Country:US
Practice Address - Phone:641-856-8684
Practice Address - Fax:641-856-3009
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA4305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1972867810Medicaid