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Individual

ROBERT E VANDEMARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1210 W 18TH ST, STE G-01, SIOUX FALLS, SD 57104-4647
(605) 328-3700
(605) 328-3701
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9556
(605) 328-9501

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2405
SD
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
2405
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6400314
SD
Enumeration date
07/05/2005
Last updated
06/10/2019
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