Individual
MICHAEL J AANDERUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7220 S HIGHWAY 16, RAPID CITY, SD 57702-8708
(605) 341-1414
(605) 341-7062
Mailing address
7220 MOUNT RUSHMORE RD, PO BOX 6850, RAPID CITY, SD 57702-8754
(605) 341-1414
(605) 341-7062
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0451
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1254560001
CIGNA MEDICARE
SD
05
—
6824060
—
SD
01
—
970027652
MEDICARE RAILROAD PTAN
—
Enumeration date
01/19/2006
Last updated
05/19/2017
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