Basic Information
Provider Information
NPI: 1013904655
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VAINIO
FirstName: ARNE
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 927 TRETTEL LN
Address2:  
City: CLOQUET
State: MN
PostalCode: 557201345
CountryCode: US
TelephoneNumber: 2188791227
FaxNumber:  
Practice Location
Address1: 927 TRETTEL LN
Address2:  
City: CLOQUET
State: MN
PostalCode: 557201345
CountryCode: US
TelephoneNumber: 2188791227
FaxNumber: 2188782136
Other Information
ProviderEnumerationDate: 09/29/2005
LastUpdateDate: 06/03/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/03/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X40356MNY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
97221810005MN MEDICAID


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