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Individual
RENE ELDIDY JR.
Active
Individual
RENE ELDIDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36275
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128951
MEDICA HEALTH PLANS
—
01
—
080128013
RR MEDICARE
—
01
—
1006863
PREFERRED ONE
—
01
—
108065200
MEDICAL ASSISTANCE MA
—
01
—
115064
UCARE
—
01
—
54Q39EL
BLUE CROSS BLUE SHIELD
—
01
—
638516
ARAZ GROUP AMERICAS PPO
—
01
—
C11369
RR MEDICARE
—
01
—
HP27075
HEALTH PARTNERS
—
Enumeration date
11/02/2005
Last updated
01/07/2013
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