Individual
MARK R DAHLQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R019050
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065156
SD BC PROVIDER #
SD
01
—
013K2DA
MN BC PROVIDER #
FM
05
—
2120394
—
IA
01
—
460224743-57105-AE54
TRICARE PROVIDER #
SD
05
—
46022474348
—
NE
05
—
5752054
—
SD
01
—
R019050
DAKOTACARE PROVIDER #
SD
Enumeration date
07/31/2006
Last updated
02/21/2008
Update your record
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