Individual
EDGARDO FORTUNO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1309 W 17TH ST STE 101, SIOUX FALLS, SD 57104-8805
(605) 328-8000
(605) 328-8001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(216) 445-1007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58.008242
OH
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
12320
SD
Other
Enumeration date
05/10/2017
Last updated
03/28/2022
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