Basic Information
| Provider Information | |||||||||
| NPI: | 1285602649 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WELCH | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86370 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571186370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227510 | ||||||||
| FaxNumber: | 6053226475 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 E. 21ST ST. | ||||||||
| Address2: | STE 301 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 57105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053227350 | ||||||||
| FaxNumber: | 6053227351 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 03/02/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 0617 | SD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | 412871046552 | 01 | SD | PREFERRED ONE | OTHER | 46022474346 | 05 | NE | MEDICAID | 0123475 | 01 | SD | MEDICA | OTHER | 126H0WE | 01 | MN | BLUE CROSS | OTHER | 2442941 | 01 | SD | ARAZ/ AMERICA'S PPO | OTHER | 6828652 | 05 | SD | MEDICAID | 9238093 | 01 | SD | DAKOTACARE | OTHER | 370624200 | 01 | SD | DEPT OF LABOR | OTHER | 57105R009 | 01 | SD | WPS TRICARE | OTHER | 0552638 | 05 | IA | MEDICAID | 12976 | 05 | ND | MEDICAID | 250267 | 01 | SD | MIDLANDS CHOICE | OTHER | 126H0WE | 01 | MN | CC SYSTEMS/ BLUE PLUS | OTHER | 468669100 | 05 | MN | MEDICAID | 4994112 | 01 | SD | BLUE CROSS | OTHER | HP61153 | 01 | SD | HEALTHPARTNERS | OTHER | 6828650 | 05 | SD | MEDICAID |