Individual
ROBERT A VENNERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
712 SOUTH CASCADE STREET, FERGUS FALLS, MN 56537-2813
(218) 736-8000
(218) 739-6742
Mailing address
712 SOUTH CASCADE STREET, FERGUS FALLS, MN 56537-2813
(218) 736-8000
(218) 739-6742
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33413
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00794
MEDICAFFMG&WRC
MN
01
—
01-14533
MEDICABLC
MN
05
—
093007500
—
MN
01
—
1008800
PREFERREDONE
MN
01
—
109371
UCAREMN
MN
05
—
200383400A
—
IN
05
—
232419
—
OR
05
—
41091744413
—
NE
01
—
80532VE
BCBS
MN
05
—
806646400
—
ID
01
—
HP27402
HEALTHPARTNERS
MN
Enumeration date
09/26/2006
Last updated
02/16/2017
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