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NPI Code Detail

MEDICARE: GENERAL SURGERY AND DIAGNOSTICS PC

MEDICARE: GENERAL SURGERY AND DIAGNOSTICS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003860594
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERAL SURGERY AND DIAGNOSTICS PC
Provider Business Mailing Address
First Line : 612 N SIOUX POINT RD
Second Line : SUITE 400
City : DAKOTA DUNES
State : SD
Zip : 57049-5088
Country : US
Telephone Number : 605-232-6353
Fax Number :
Provider Business Practice Location Address
First Line : 612 N SIOUX POINT RD
Second Line : SUITE 400
City : DAKOTA DUNES
State : SD
Zip : 57049-5088
Country : US
Telephone Number : 605-232-6353
Fax Number :
Authorized Official
Title or Position : ASSISTANT OFFICE MANAGER
Name : CINDY HESSE
Credential :
Telephone Number : 605-232-6353
Provider Enumeration Date : 05/20/2006
Last Update Date : 10/31/2007

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Directions to “GENERAL SURGERY AND DIAGNOSTICS PC ” Practice Location

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