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71 Charles St Deadwood SD 57732-1303 | |
(605) 717-6431 | |
(605) 717-8033 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 71 Charles St, Deadwood, South Dakota |
Authorized Official Name and Position | Mark C Schmidt (PRESIDENT CUSTER LD-DWD HOSPITAL) |
Authorized Official Contact | 6057176020 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 860013 Minneapolis MN 55486-0013 Ph: (605) 717-6431 | 71 Charles St Deadwood SD 57732-1303 Ph: (605) 717-6431 |
NPI Number | 1033597760 |
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Provider Enumeration Date | 05/14/2015 |
Last Update Date | 03/16/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033597760 | NPI | - | NPPES |
10535 | Other | SD | SD LICENSE |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (South Dakota) | Primary |