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SAGE MEDICAL PROF LLC NPI 1588156657


NPI Information

NPI: 1588156657
Provider Name: SAGE MEDICAL PROF LLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
345 W STEAMBOAT DR STE 701
DAKOTA DUNES, SD
ZIP 57049
Phone: (319) 430-9340
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SAGE MEDICAL PROF LLC is a vascular surgery surgery in Dakota Dunes, SD. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. SAGE MEDICAL PROF LLC NPI is 1588156657. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

345 W STEAMBOAT DR STE 701
DAKOTA DUNES, SD
ZIP 57049-287
Phone: (319) 430-9340

The provider's authorized official is Chad Roger Laurich .
The authorized official title is Medical Director, Owner and has the following contact phone number (319) 430-9340.

The enumeration date for this NPI number is 6/4/2018 and was last updated on 6/4/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17960OTHERSOUTH DAKOTASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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