Individual
DR. BRUCE A WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
PO BOX 5009, SIOUX FALLS, SD 57117-5009
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1655
SD
207RI0011X
Interventional Cardiology Physician
1655
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003371
SD BCBS
SD
05
—
0933036
—
IA
01
—
165035
UCARE
—
01
—
1655
DAKOTACARE
SD
01
—
24694
HEALTH PARTNERS
—
01
—
25-00495
MEDICA SELECTCARE
—
05
—
415088100
—
MN
01
—
4T612WA
MN BCBS - PLAN 91057NO
MN
01
—
53997
IA BCBS
IA
01
—
539ROWA
MN BCBS - PLAN 538R2NO
MN
05
—
6000872
—
SD
01
—
931451029050
PREFERRED ONE
—
Enumeration date
05/22/2006
Last updated
08/18/2021
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