Healthcare Provider Details
I. General information
NPI: 1053055111
Provider Name (Legal Business Name): JOSHUA REIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/25/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4400 W 69TH ST
SIOUX FALLS SD
57108-8170
US
IV. Provider business mailing address
4400 S BIRCHWOOD AVE
SIOUX FALLS SD
57103-5132
US
V. Phone/Fax
- Phone: 605-322-5737
- Fax:
- Phone: 160-535-9986
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 0660 |
| License Number State | SD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: