MEDICARE: ROBERT SAGE M.D.

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	207ND0101X	MOHS-Micrographic Surgery Physician	8156	SD
2	207NS0135X	Procedural Dermatology Physician	8156	SD
3	207N00000X	Dermatology Physician	8156	SD

General Provider Information

NPI Number	:	1861684748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SAGE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1737
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57709-1737
Country	:	US
Telephone Number	:	605-608-3376
Fax Number	:	605-608-3550

Provider Business Practice Location Address
First Line	:	2820 MOUNT RUSHMORE RD STE 200
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-5462
Country	:	US
Telephone Number	:	605-608-3376
Fax Number	:	605-608-3550

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	05/15/2026

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