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Individual

LARRY L TEUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9701 CLARKSON RD, RAPID CITY, SD 57702-9100
(605) 484-1616
(605) 394-9307
Mailing address
9701 CLARKSON RD, RAPID CITY, SD 57702-9100
(605) 484-1616
(605) 394-9307

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
3403
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002709
WELLMARK BCBS PIN
SD
05
103250000
WY
01
1477512036
NPI
SD
01
3403
DAKOTACARE PIN
SD
05
6100332
SD
Enumeration date
03/22/2006
Last updated
11/07/2012
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