Individual
DR. KENT DOUGLAS ANDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 W 22ND ST, SIOUX FALLS, SD 57105-1505
(605) 357-1300
Mailing address
516 W DARTMOUTH ST, VERMILLION, SD 57069-1924
(605) 624-6489
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7583
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7102790
—
SD
01
—
P00832291
RR MEDICARE
SD
Enumeration date
09/06/2007
Last updated
07/27/2010
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