Individual
GLENN A. RIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6110 S MINNESOTA AVE, SIOUX FALLS, SD 57108-2549
(605) 328-5800
(605) 328-5814
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3483
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5609275
—
SD
Enumeration date
07/22/2005
Last updated
03/31/2022
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