Healthcare Provider Details

I. General information

NPI: 1346747250
Provider Name (Legal Business Name): REBECCA MICHELLE DURON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2018
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W 49TH ST STE 104
SIOUX FALLS SD
57105-6550
US

IV. Provider business mailing address

2200 W 49TH ST STE 104
SIOUX FALLS SD
57105-6550
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-6385
  • Fax: 605-336-6513
Mailing address:
  • Phone: 605-336-6385
  • Fax: 605-336-6513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number15051
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: