Individual
RANDOLPH J REISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 DIVISION ST S, NORTHFIELD, MN 55057-2468
(507) 646-1494
Mailing address
1202 9TH AVE W, MOBRIDGE, SD 57601-1210
(605) 845-3582
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
102423
MN
207R00000X
Internal Medicine Physician
5242
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6004640
—
SD
Enumeration date
12/01/2005
Last updated
03/10/2021
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