Provider Demographics
NPI:1194810838
Name:ARNE, STEPHEN P (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:ARNE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13911 RIDGEDALE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1773
Mailing Address - Country:US
Mailing Address - Phone:952-697-3100
Mailing Address - Fax:952-541-1756
Practice Address - Street 1:13911 RIDGEDALE DR STE 100
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1773
Practice Address - Country:US
Practice Address - Phone:952-697-3100
Practice Address - Fax:952-541-1756
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN204M0AROtherBCBS PID
MN367174700Medicaid
MN203M8AROtherBCBS CLINIC
MN014327800Medicaid
MN014327800Medicaid
MNP00083451Medicare ID - Type UnspecifiedRR MEDICARE IPN
MNC03260Medicare ID - Type UnspecifiedMEDICARE CLINIC
MN204M0AROtherBCBS PID
MN350002839Medicare ID - Type UnspecifiedMEDICARE PID