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Individual

CY B HAATVEDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
455 KANSAS AVE SE, HURON, SD 57350-2522
(605) 352-8767
(605) 352-8784
Mailing address
PO BOX 1411, HURON, SD 57350-1411
(605) 352-8767
(605) 352-8784

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3838
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0003451
WELLMARK
SD
01
020026365
RAILROAD MEDICARE
SD
01
3838
DAKOTACARE
SD
05
7300560
SD
Enumeration date
06/20/2005
Last updated
11/03/2009
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