Individual
SHERRI DANELLE KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4447 S CANYON RD, SUITE 6, RAPID CITY, SD 57702-1807
(605) 721-6426
(605) 721-5515
Mailing address
PO BOX 346, RAPID CITY, SD 57709-0346
(605) 721-6426
(605) 721-5515
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28953
AZ
207Q00000X
Family Medicine Physician
Primary
4447
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5620280
—
SD
05
—
738891
—
AZ
01
—
S105195
MEDICARE PTAN
SD
Enumeration date
05/31/2006
Last updated
02/11/2017
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