Individual
BAYAN AL SHARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(248) 949-9054
Mailing address
353 FAIRMONT BLVD, RAPID CITY, SD 57701-7375
(248) 949-9054
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
12996
SD
390200000X
Student in an Organized Health Care Education/Training Program
4301110652
MI
Other
Enumeration date
07/16/2016
Last updated
08/10/2022
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