Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 2297 | SD |
NPI | 1013027655 |
---|---|
Provider Name | Gerald W Butz |
First Address | Rapid City, SD 57701-4670 |
Second Address | Rapid City, SD 57701-4670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 21/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000440 | BLUE CROSS BLUE SHIELD (01) | SD |
2297 | DAKOTACARE (01) | SD |
23142 | SANFORD HEALTH (01) | SD |
23142 | SIOUX VALLEY HEALTH PLAN (01) | SD |
310276 | BLUE CROSS BLUE SHIELD (01) | WY |
7500082 | (05) | SD |
D28450 | (02) | SD |
S440 | MEDICARE SD (01) | SD |