Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 1688 | SD |
Y | 207R00000X | Internist | 1688 | SD |
Y | 111NI0900X | Internist | 1688 | SD |
NPI | 1275637977 |
---|---|
Provider Name | Dr. Ellen Mary Pinholt |
First Address | Rapid City, SD 57701-6000 |
Second Address | Rapid City, SD 57701-4679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 28/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) |