Individual
DEAN A DEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 E 26TH ST, SIOUX FALLS, SD 57105-4023
(605) 338-7098
Mailing address
601 S CLIFF AVE, STE A, SIOUX FALLS, SD 57104-5275
(605) 338-7098
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
47320
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
456D9DE
BLUE CROSS
MN
01
—
4993021
BLUE CROSS
SD
05
—
5707290
—
SD
05
—
642697200
—
MN
05
—
S101893
—
SD
Enumeration date
02/09/2006
Last updated
05/12/2020
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