Individual
MARK R DAHLQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 E 21ST ST, SIOUX FALLS, SD 57105-1016
(605) 322-2754
(605) 322-2727
Mailing address
800 E 21ST ST, SIOUX FALLS, SD 57105-1016
(605) 322-2754
(605) 322-2727
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
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