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Individual

DR. ELIZABETH DIANE RUBIN-PECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1600 W 22ND ST, SIOUX FALLS, SD 57105-1521
(605) 312-1000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8400
SD
208000000X
Pediatrics Physician
94-06746
KS
208M00000X
Hospitalist Physician
Primary
8400
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200675960A
KS
01
KA2129017
MEDICARE PTAN
KS
Enumeration date
06/25/2007
Last updated
12/05/2017
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