Nicholas John Kolterman, C.PED

Individual provider Active NPI Specialist · Sioux Falls, SD

NPI 1013245679 · NPPES record last updated Jul 19, 2010

Key facts

NPI
1013245679
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
D00006 (SD)
Practice address
810 E 23Rd St
Sioux Falls, SD 57105-2135
Phone
(605) 977-6845
Fax
(605) 332-5844
NPI assigned
Nov 19, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
D00006SDMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D00006 SD Yes

Addresses

Primary practice location

810 E 23Rd St
Sioux Falls, SD 57105-2135

Mailing address

810 E 23Rd St
Sioux Falls, SD 57105-2135
Phone (605) 977-6845

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Specialist in South Dakota

Sources for this page

Verify at the official NPI Registry.