Individual
DR. RICHARD A. WAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 22ND AVE., BROOKINGS, SD 57006-2497
(605) 697-9500
(605) 697-6939
Mailing address
400 22ND AVE., BROOKINGS, SD 57006-2497
(605) 697-9500
(605) 697-6939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2188
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5600292
—
SD
Enumeration date
05/11/2006
Last updated
04/30/2008
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