Individual
MELVIN WALLINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
410 WEST 16TH AVE, TYNDALL, SD 57066-0027
(605) 589-3341
(605) 589-3288
Mailing address
BON HOMME FAMILY PRACTICE, 410 W 16TH AVE, TYNDALL, SD 57066-2318
(605) 589-2190
(605) 589-2115
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5033
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4996770
BCBS
SD
05
—
5601810
—
SD
01
—
9205043
DAKOTACARE
SD
Enumeration date
06/15/2006
Last updated
08/25/2020
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