Basic Information
Provider Information
NPI: 1346475787
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUTER
FirstName: SARA
MiddleName: JEANNE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOOGERS
OtherFirstName: SARA
OtherMiddleName: JEANNE
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 5074
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571175074
CountryCode: US
TelephoneNumber: 6053286585
FaxNumber: 6053286512
Practice Location
Address1: 1205 S GRANGE
Address2: SUITE 510
City: SIOUX FALLS
State: SD
PostalCode: 57105
CountryCode: US
TelephoneNumber: 6053287500
FaxNumber: 6053287599
Other Information
ProviderEnumerationDate: 05/28/2009
LastUpdateDate: 04/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XSDTP70SDN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X8523SDY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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