Individual
LESLIE ADAJAR VAN DYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(605) 755-1000
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
13724
SD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2015
Last updated
10/06/2022
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