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NPI Code Detail

MEDICARE: CRAIG J. UTHE MD

MEDICARE: CRAIG J. UTHE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician3479SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174523674
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG J. UTHE MD
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-9556
Fax Number : 605-328-9501
Provider Business Practice Location Address
First Line : 3401 W 49TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-2318
Country : US
Telephone Number : 605-328-1850
Fax Number : 605-328-1855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 03/28/2022

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