Individual
MARK SCOTT VANTASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 W 22ND ST, SIOUX FALLS, SD 57105-1554
(605) 357-1300
Mailing address
120 AMHURST ST, IOWA CITY, IA 52245-4006
(801) 718-3845
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MED-PHYS-LIC-54752
MT
Other
Enumeration date
04/21/2011
Last updated
04/05/2024
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