Individual
ELOY P MALSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 8TH AVE NW, ABERDEEN, SD 57401-1803
(605) 225-3300
Mailing address
508 6TH ST STE 201, PO BOX 8265, RAPID CITY, SD 57701-2722
(605) 721-0337
(605) 721-0043
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000259
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5751502
—
SD
Enumeration date
07/13/2006
Last updated
07/08/2007
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