Individual
DR. VASSILIA D YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7236 JORDAN DR STE 101, RAPID CITY, SD 57702-8740
(605) 341-5565
(605) 341-5595
Mailing address
PO BOX 6540, RAPID CITY, SD 57709-6540
(605) 341-5565
(605) 341-5595
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4069
SD
207ND0101X
MOHS-Micrographic Surgery Physician
4069
SD
207ND0900X
Dermatopathology Physician
4069
SD
207NP0225X
Pediatric Dermatology Physician
4069
SD
207NS0135X
Procedural Dermatology Physician
4069
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040886
WELLMARK BCBS NUMBER
SD
05
—
116997100
—
WY
01
—
311267
WYOMING BCBS NUMBER
WY
01
—
460461314
TRICARE NUMBER
SD
05
—
46046131400
—
NE
05
—
5900103
—
SD
Enumeration date
02/07/2006
Last updated
01/15/2016
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