Individual
RUSSELL C PIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5100
(605) 622-4030
Mailing address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5100
(605) 622-4030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4105
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11631
—
ND
05
—
6003202
—
SD
05
—
6003203
—
SD
Enumeration date
06/09/2005
Last updated
09/28/2016
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