Provider Demographics
NPI:1124097027
Name:LARSON, VALERIE A (MD)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:A
Last Name:LARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 8
Mailing Address - Street 2:
Mailing Address - City:DELL RAPIDS
Mailing Address - State:SD
Mailing Address - Zip Code:57022-1208
Mailing Address - Country:US
Mailing Address - Phone:605-428-5446
Mailing Address - Fax:
Practice Address - Street 1:111 10TH STREET
Practice Address - Street 2:
Practice Address - City:DELL RAPIDS
Practice Address - State:SD
Practice Address - Zip Code:57022-1208
Practice Address - Country:US
Practice Address - Phone:605-428-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1402966OtherAMERICAS PPO
SD4996052OtherWELLMARK BCBS OF SD
0108605OtherMEDICA
57022A009OtherTRICARE
SD0008142OtherWELLMARK BCBS OF SD
SD4884OtherDAKOTACARE
MN55F71LAOtherBCBS OF MN
AH9021028613OtherPREFFERED ONE
SD5610960Medicaid
SD5610962Medicaid
MN063425500Medicaid
233740OtherMIDLANDS CHOICE
0108605OtherMEDICA
SD4996052OtherWELLMARK BCBS OF SD
233740OtherMIDLANDS CHOICE