Provider Demographics
NPI:1558175042
Name:ARNUMENTARIUM MEDICAL PRACTICE INC
Entity type:Organization
Organization Name:ARNUMENTARIUM MEDICAL PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIEN
Authorized Official - Middle Name:VIET
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-757-6505
Mailing Address - Street 1:1585 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-1225
Mailing Address - Country:US
Mailing Address - Phone:814-757-6505
Mailing Address - Fax:814-757-4310
Practice Address - Street 1:1585 MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:PA
Practice Address - Zip Code:16365-1225
Practice Address - Country:US
Practice Address - Phone:814-757-6505
Practice Address - Fax:814-757-4310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARNUMENTARIUM MEDICAL PRACTICE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty