Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 3625 | SD |
NPI | 1295782613 |
---|---|
Provider Name | Stephen R Karl |
First Address | Sioux Falls, SD 57117-5126 |
Second Address | Sioux Falls, SD 57105-1033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 22/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0560110 | (05) | IA |
12361 | (05) | ND |
474283400 | (05) | MN |
4996458 | BCBS (01) | SD |
6630202 | (05) | SD |
C31003 | (02) |