Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 7532 | NE |
N | 111NI0900X | Internist | 7532 | NE |
Y | 207RP1001X | Pulmonary Disease | 12729 | SD |
NPI | 1003298373 |
---|---|
Provider Name | Cliff Janikowski |
First Address | Rapid City, SD 57701-7375 |
Second Address | Rapid City, SD 57701-7375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2015 |
Last Update Date | 07/07/2021 |