Provider Demographics
NPI:1770543647
Name:VIRNIG, ARDEN EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:ARDEN
Middle Name:EDWARD
Last Name:VIRNIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ELM ST N
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:56359-7901
Mailing Address - Country:US
Mailing Address - Phone:320-532-3154
Mailing Address - Fax:320-532-3111
Practice Address - Street 1:200 ELM ST N
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:56359-7901
Practice Address - Country:US
Practice Address - Phone:320-532-3154
Practice Address - Fax:320-532-3111
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-29393OtherMEDICA HILLMAN
MN2D657VIOtherBLUE CROSS CLINICS
MN06F84VIOtherBLUE CROSS HOSPITAL
MN01-22838OtherMEDICA ONAMIA
ND18358Medicaid
MN01-22837OtherMEDICA ISLE
MNHP20618OtherHEALTH PARTNERS
MN109385OtherUCARE
MN400305500Medicaid
MNNA9090733001OtherPREFERRED ONE
MN01-22838OtherMEDICA ONAMIA
MN109385OtherUCARE
E57968Medicare UPIN
MN400305500Medicaid
MN06F84VIOtherBLUE CROSS HOSPITAL
MN080014422Medicare ID - Type UnspecifiedISLE CLINIC