Healthcare Provider Details

I. General information

NPI: 1649920729
Provider Name (Legal Business Name): WILLIAM GRANT SCHULTHEIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 W 57TH ST
SIOUX FALLS SD
57108-3162
US

IV. Provider business mailing address

3101 W 57TH ST
SIOUX FALLS SD
57108-3162
US

V. Phone/Fax

Practice location:
  • Phone: 605-361-3937
  • Fax: 605-371-7199
Mailing address:
  • Phone: 605-361-3937
  • Fax: 605-371-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number18673
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: