NPI 1689831091 · live from the CMS NPI Registry
Black Hills Dermatology PC
Dermatology in Spearfish, SD. National Provider Identifier 1689831091, active.
NPI record
| NPI | 1689831091 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 132 E Grant St, Spearfish, SD 57783 |
| Practice phone | 605-722-9090 |
| Mailing address | Po Box 6540, 7236 Jordan Drive Ste 101, Rapid City, SD 57709 |
| Enumerated | May 22, 2008 |
| Last updated | January 30, 2015 |
| Authorized official | Jason Gorman, Administrator |
| Other names | Spearfish Clinic |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | 0370 (SD) |
| Dermatology, Dermatopathology | 207ND0900X | 0370 (SD) |
| Dermatology, Pediatric Dermatology | 207NP0225X | 0370 (SD) |
| Dermatology primary | 207N00000X | 0370 (SD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.