Individual
ROBERT EUGENE VAN DEMARK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 W 18TH ST STE G01, SIOUX FALLS, SD 57104-4651
(605) 328-2663
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-2663
(605) 312-9802
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10520
SD
207X00000X
Orthopaedic Surgery Physician
2016-00257
NC
207X00000X
Orthopaedic Surgery Physician
55491
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063708915
—
NC
05
—
NC2779
—
SC
Enumeration date
06/20/2011
Last updated
06/06/2023
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