Individual
DR. BARNEY DANIEL STOUTAMIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W 18TH ST, STE LL03, SIOUX FALLS, SD 57104-4647
(605) 328-1410
Mailing address
PO BOX 91407, SIOUX FALLS, SD 57109-1407
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
201000986
NC
2085R0202X
Diagnostic Radiology Physician
4301085978
MI
2085R0202X
Diagnostic Radiology Physician
Primary
8399
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02898
WORK COMP
NC
01
—
158TR
BCBS NC STATE
NC
01
—
2076199
MEDICARE
NC
05
—
5915655
—
NC
Enumeration date
05/02/2007
Last updated
06/05/2012
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