MEDICARE: MR. ROLF A NORLIN 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
1	207Q00000X	Family Medicine Physician	4488	SD

General Provider Information

NPI Number	:	1346296639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROLF A NORLIN MD

Provider Business Mailing Address
First Line	:	914 SAINT CHARLES ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-4530
Country	:	US
Telephone Number	:	605-721-0942
Fax Number	:

Provider Business Practice Location Address
First Line	:	914 SAINT CHARLES ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-4530
Country	:	US
Telephone Number	:	605-718-5127
Fax Number	:	605-388-4621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	05/18/2015

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