MEDICARE: STEPHEN PAUL MANLOVE 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	2084P0800X	Psychiatry Physician	1887	SD

Other Identifiers

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

General Provider Information

NPI Number	:	1619021672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN PAUL MANLOVE MD

Provider Business Mailing Address
First Line	:	636 SAINT ANNE ST
Second Line	:	SUITE 100
City	:	RAPID CITY
State	:	SD
Zip	:	57701-4694
Country	:	US
Telephone Number	:	605-348-8000
Fax Number	:	605-348-4315

Provider Business Practice Location Address
First Line	:	636 SAINT ANNE ST
Second Line	:	SUITE 100
City	:	RAPID CITY
State	:	SD
Zip	:	57701-4694
Country	:	US
Telephone Number	:	605-348-8000
Fax Number	:	605-348-4315

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/10/2025

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