Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | CP002257 | SD |
NPI | 1124789540 |
---|---|
Provider Name | Stephanie Lyn Dargatz |
First Address | Webster, SD 57274-5700 |
Second Address | Milbank, SD 57252-1508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2022 |
Last Update Date | 07/01/2022 |