Pietz, Russell C
Pietz, Russell C is an individual health care provider with primary practice located at 305 S State St , Aberdeen SD 57401-4527. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Pietz, Russell C can be contacted via phone (605) 622-5100.Contact Information
Primary practice address
305 S State St
Aberdeen SD 57401-4527
Phone: (605) 622-5100
Fax: (605) 622-4030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 4105 | South Dakota |
Profile Details
| NPI number | 1790789543 |
|---|---|
| LBN Legal business name | Pietz, Russell C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Sep 28th, 2016 - about 8 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 | 1790789543 | NPPES |
| South Dakota | MEDICAID | 6003203 | |
| South Dakota | MEDICAID | 6003202 | |
| South Dakota | MEDICAID | 11631 |
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