Healthcare Provider Details

I. General information

NPI: 1871590547
Provider Name (Legal Business Name): DANIEL WARREN TODD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 W 57TH ST
SIOUX FALLS SD
57108-5046
US

IV. Provider business mailing address

2315 W 57TH ST
SIOUX FALLS SD
57108-5046
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-3503
  • Fax: 605-336-6010
Mailing address:
  • Phone: 605-336-3503
  • Fax: 605-336-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number5104
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: