Basic Information
| Provider Information | |||||||||
| NPI: | 1437130580 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOLIEN | ||||||||
| FirstName: | ARLYS | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1520 NORTHWAY DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563034478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202511775 | ||||||||
| FaxNumber: | 3202403131 | ||||||||
| Practice Location | |||||||||
| Address1: | 1520 NORTHWAY DR | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563034478 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202511775 | ||||||||
| FaxNumber: | 3202403131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20908 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 110933 | 01 | UCARE | OTHER | 86D77SO | 01 | BLUE CROSS BLUE SHIELD | OTHER | 0129007 | 01 | MEDICA HEALTH PLANS | OTHER | 456504 | 01 | PREFERRED ONE | OTHER | HP22746 | 01 | HEALTH PARTNERS | OTHER | 2114044 | 01 | FIRST HEALTH PLAN | OTHER | 603471 | 01 | ARAZ GROUP AMERICAS PPO | OTHER | AS5614703 | 01 | MN | DEA | OTHER |