Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 4288 | SD |
NPI | 1447341003 |
---|---|
Provider Name | David C Bartsch |
First Address | Rapid City, SD 57709-3450 |
Second Address | Rapid City, SD 57701-7375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 12/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6630383 | (05) | SD |
A95147 | (02) |