| Eduardo Ehrenwald, MD | |
|
407 E 3rd St, Duluth, MN 55805-1950 | |
| (218) 786-4897 | |
| (218) 786-4980 |
| Full Name | Eduardo Ehrenwald |
|---|---|
| Gender | Male |
| Speciality | Radiology - Vascular & Interventional Radiology |
| Location | 407 E 3rd St, Duluth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710930110 | NPI | - | NPPES |
| P00313965 | Other | MN | RAILROAD MEDICARE MN |
| 087686100 | Medicaid | MN | |
| 1604022 | Other | MN | MEDICA |
| 1716951 | Medicaid | IA | |
| HP60559 | Other | MN | HEALTHPARTNERS |
| 2437705 | Other | MN | AMERICA'S PPO |
| 2437705 | Other | MN | WEA TRUST |
| 95G99EH | Other | MN | BLUE CROSS BLUE SHIELD |
| 1046525 | Other | MN | PREFERRED ONE |
| 138133 | Other | MN | UCARE |
| 34838300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 48355 (Minnesota) | Primary |
| Entity Name | Pine Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1326041633 PECOS PAC ID: 3870406945 Enrollment ID: O20061104000642 |
| Entity Name | Brainerd Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295801777 PECOS PAC ID: 0648270272 Enrollment ID: O20070105000140 |
| Mailing Address | Practice Location Address |
|---|---|
| Eduardo Ehrenwald, MD 407 E 3rd St, Duluth, MN 55805-1950 Ph: (218) 786-4897 | Eduardo Ehrenwald, MD 407 E 3rd St, Duluth, MN 55805-1950 Ph: (218) 786-4897 |
Bruce James Derauf, Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 | |
Mrs. Rebecca Lynn Kuntz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 925 E Superior St, Suite 109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Matthew Steven Wagner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Kenneth Dornfeld, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 East 3rd Street, Duluth, MN 55805 Phone: 218-786-8364 | |
Dr. William E. Johnson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 925 E Superior St, Suite109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Ryan Patrick Wippler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Michael Edward Ryan, Radiology Medicare: Medicare Enrolled Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 |