Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 4708 | SD |
NPI | 1033188594 |
---|---|
Provider Name | Stuart Glen Rice |
First Address | Rapid City, SD 57701-6021 |
Second Address | Rapid City, SD 57701-6021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 04/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007348 | WELLMARK BCBS PROVIDER # (01) | SD |
22521 | ND BCBS PROVIDER NUMBER (01) | ND |
6100650 | (05) | SD |
F28915 | (02) |