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NPI Code Detail

MEDICARE: CARSTON CHARLES MERTENS

MEDICARE: CARSTON CHARLES MERTENS
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
1171M00000XCase Manager/Care CoordinatorSD

General Provider Information

NPI Number : 1710819107
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARSTON CHARLES MERTENS
Provider Business Mailing Address
First Line : 350 ELK ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7351
Country : US
Telephone Number : 605-343-7262
Fax Number : 605-343-7293
Provider Business Practice Location Address
First Line : 111 NORTH ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-1163
Country : US
Telephone Number : 605-343-0650
Fax Number : 605-342-3692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ CARSTON CHARLES MERTENS ” Practice Location

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