Individual
MICHAEL D GILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 W 69TH ST, SIOUX FALLS, SD 57108-2403
(605) 336-0635
(605) 271-0543
Mailing address
201 W 69TH ST, SIOUX FALLS, SD 57108-2403
(605) 336-0635
(605) 271-0543
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
43656
MN
208800000X
Urology Physician
5878
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0749101
—
IA
05
—
165167600
—
MN
05
—
7500490
—
SD
01
—
P00337027
RAILROAD MEDICARE
SD
Enumeration date
12/30/2005
Last updated
02/01/2012
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