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CLAYTON GERALD VANBALEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
900 E 54TH ST N, SIOUX FALLS, SD 57104
(605) 338-9300
(605) 338-9301
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2540
SD
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
2540
SD
2083X0100X
Occupational Medicine Physician
Primary
2540
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5602923
SD
Enumeration date
06/24/2005
Last updated
03/02/2021
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