Individual
DR. ROGER STEVEN KNUTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 MEADE ST, SUITE 100, RAPID CITY, SD 57701-5103
(605) 341-5910
(605) 341-9052
Mailing address
717 MEADE ST, SUITE 100, RAPID CITY, SD 57701-5103
(605) 341-5910
(605) 341-9052
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
1796
SD
207ND0101X
MOHS-Micrographic Surgery Physician
1796
SD
207NS0135X
Procedural Dermatology Physician
1796
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009994
BLUE CROSS BLUE SHIELD
SD
05
—
5900222
—
SD
Enumeration date
01/24/2006
Last updated
03/11/2008
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