NPI 1285833459 · live from the CMS NPI Registry
Jacob Kusmak
Dermatology in Sioux Falls, SD. National Provider Identifier 1285833459, active.
NPI record
| NPI | 1285833459 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 1310 W 22nd St, Sioux Falls, SD 57105 |
| Practice phone | 605-328-8600 |
| Mailing address | Po Box 5074, Sioux Falls, SD 57117 |
| Enumerated | July 17, 2007 |
| Last updated | April 29, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist | 183500000X | 5144 (SD) |
| Dermatology primary | 207N00000X | pending (SD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.