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Individual

MR. FRED S LANDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3015 3RD AVE SE, ABERDEEN, SD 57401-5418
(605) 725-1700
(605) 725-1761
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
12144
ND
207L00000X
Anesthesiology Physician
Primary
4290
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050071558
RR MEDICARE
05
10367
ND
Enumeration date
02/21/2006
Last updated
05/01/2014
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