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Individual

DR. MARK D FAUSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
PO BOX 5009, SIOUX FALLS, SD 57117-5009
(605) 977-5000
(605) 977-5377

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4275
SD
207RI0011X
Interventional Cardiology Physician
4275
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0501205
IA
01
132666
UCARE
01
24696
HEALTH PARTNERS
01
24749
IA BCBS
IA
01
25-00470
MEDICA SELECTCARE
05
422522800
MN
01
4275
DAKOTACARE
SD
01
4998788
SD BCBS
SD
05
6003430
SD
01
89A46FA
MN BCBS - PLAN 91057NO
MN
01
931451029032
PREFERRED ONE
MN
01
MN BLUE SHIELD
497L2FA
MN
Enumeration date
04/27/2006
Last updated
06/10/2008
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