Famestad, Gary L
Famestad, Gary L is an individual health care provider with primary practice located at 1210 W 18Th St Ste Ll03, Sioux Falls SD 57104-4647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Famestad, Gary L can be contacted via phone (605) 328-1410.Contact Information
Primary practice address
1210 W 18Th St Ste Ll03
Sioux Falls SD 57104-4647
Phone: (605) 328-1410
Fax: (605) 328-1412
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 1934 | South Dakota |
Profile Details
| NPI number | 1811959323 |
|---|---|
| LBN Legal business name | Famestad, Gary L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2006 |
| Last updated | Apr 3rd, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811959323 | NPPES |
| South Dakota | MEDICAID | 7202370 |
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