Provider Demographics
NPI:1063508331
Name:NEMECHEK, CRAIG ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ROBERT
Last Name:NEMECHEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:705 N SIOUX POINT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5091
Mailing Address - Country:US
Mailing Address - Phone:605-217-5500
Mailing Address - Fax:605-217-5515
Practice Address - Street 1:705 N SIOUX POINT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5091
Practice Address - Country:US
Practice Address - Phone:605-217-5500
Practice Address - Fax:605-217-5515
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD8107208600000X
NE26672208600000X
IA39504208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS105060Medicare PIN
IA181310006Medicare PIN