Provider Demographics
NPI:1528157690
Name:ARENSMAN, TODD ALLEN (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:ALLEN
Last Name:ARENSMAN
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 1:99 GRIFFIN STREET
Mailing Address - Street 2:PO BOX 806
Mailing Address - City:RUTHERFORD COLLEGE
Mailing Address - State:NC
Mailing Address - Zip Code:28671-0806
Mailing Address - Country:US
Mailing Address - Phone:828-874-1316
Mailing Address - Fax:828-874-1092
Practice Address - Street 1:99 GRIFFIN STREET
Practice Address - Street 2:
Practice Address - City:RUTHERFORD COLLEGE
Practice Address - State:NC
Practice Address - Zip Code:28671-0806
Practice Address - Country:US
Practice Address - Phone:828-874-1316
Practice Address - Fax:828-874-1092
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400012207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7911700Medicaid
NC2210579AMedicare PIN
NC7911700Medicaid