Healthcare Provider Details

I. General information

NPI: 1215628128
Provider Name (Legal Business Name): SETH HOTVET
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S CLIFF AVE
SIOUX FALLS SD
57105-1007
US

IV. Provider business mailing address

6783 ZIMMERMANN DR
WENTWORTH SD
57075-7322
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-8000
  • Fax:
Mailing address:
  • Phone: 605-929-3913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number143150
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: