Healthcare Provider Details

I. General information

NPI: 1730136383
Provider Name (Legal Business Name): MARVIN E BUEHNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6015 MOUNT RUSHMORE RD STE 2
RAPID CITY SD
57701-8962
US

IV. Provider business mailing address

6015 MOUNT RUSHMORE RD STE 2
RAPID CITY SD
57701-8962
US

V. Phone/Fax

Practice location:
  • Phone: 605-343-9224
  • Fax: 605-342-1359
Mailing address:
  • Phone: 605-343-9224
  • Fax: 605-342-1359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3652
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: