Healthcare Provider Details

I. General information

NPI: 1487067385
Provider Name (Legal Business Name): ROBERT C. STELZLE MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E MINNESOTA ST SUITE 240
RAPID CITY SD
57701-7757
US

IV. Provider business mailing address

101 E MINNESOTA ST SUITE 240
RAPID CITY SD
57701-7757
US

V. Phone/Fax

Practice location:
  • Phone: 605-716-6010
  • Fax: 605-716-6011
Mailing address:
  • Phone: 605-716-6010
  • Fax: 605-716-6011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT C STELZLE
Title or Position: OWNER
Credential: MD
Phone: 605-716-6010