Individual
STEPHEN FAGERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2503 E 54TH ST N, SIOUX FALLS, SD 57104-5563
(866) 744-0621
Mailing address
601 E 69TH ST APT 317, SIOUX FALLS, SD 57108-2407
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6182
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6182
SOUTH DAKOTA BOARD OF PHARMACY
SD
Enumeration date
03/24/2015
Last updated
03/24/2015
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