MEDICARE: DR. BRUCE H REIFENRATH 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	207L00000X	Anesthesiology Physician	5845	SD

General Provider Information

NPI Number	:	1760456834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE H REIFENRATH MD

Provider Business Mailing Address
First Line	:	1000 W 4TH ST STE 13
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3700
Country	:	US
Telephone Number	:	605-668-8795
Fax Number	:	605-668-8705

Provider Business Practice Location Address
First Line	:	1000 W 4TH ST STE 13
Second Line	:
City	:	YANKTON
State	:	SD
Zip	:	57078-3700
Country	:	US
Telephone Number	:	605-668-8795
Fax Number	:	605-668-8705

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	06/23/2010

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