Healthcare Provider Details

I. General information

NPI: 1861684748
Provider Name (Legal Business Name): ROBERT SAGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 MOUNT RUSHMORE RD STE 200
RAPID CITY SD
57701-5462
US

IV. Provider business mailing address

PO BOX 1737
RAPID CITY SD
57709-1737
US

V. Phone/Fax

Practice location:
  • Phone: 605-608-3376
  • Fax: 605-608-3550
Mailing address:
  • Phone: 605-608-3376
  • Fax: 605-608-3550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number8156
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number8156
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number8156
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: