Individual
RENE ELDIDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 9TH ST SE, CENTRACARE HEALTH SYSTEM - LONG PRAIRIE, LONG PRAIRIE, MN 56347-1404
(320) 732-2131
(320) 732-6913
Mailing address
20 9TH ST SE, CENTRACARE HEALTH SYSTEM - LONG PRAIRIE, LONG PRAIRIE, MN 56347-1404
(320) 732-2131
(320) 732-6913
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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