Provider Demographics
NPI:1215279856
Name:IN'T VELD, ELISE JEAN (MD)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:JEAN
Last Name:IN'T VELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6601 S MINNESOTA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2564
Mailing Address - Country:US
Mailing Address - Phone:605-336-6294
Mailing Address - Fax:
Practice Address - Street 1:6601 S MINNESOTA AVE STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108
Practice Address - Country:US
Practice Address - Phone:605-336-6294
Practice Address - Fax:605-336-0266
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN63978207W00000X
MI4301103406207W00000X
SD10807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology