Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 8830 | SD |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | RT2213 | NH |
NPI | 1073780375 |
---|---|
Provider Name | Dr. Randall Scott Fenner |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-0401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 25/07/2013 |