Provider Demographics
NPI:1285602649
Name:WELCH, DAVID A (PA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:WELCH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1001 E. 21ST ST.
Practice Address - Street 2:STE 301
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-322-7350
Practice Address - Fax:605-322-7351
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD0617363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD412871046552OtherPREFERRED ONE
NE46022474346Medicaid
SD0123475OtherMEDICA
MN126H0WEOtherBLUE CROSS
SD2442941OtherARAZ/ AMERICA'S PPO
SD6828652Medicaid
SD9238093OtherDAKOTACARE
SD370624200OtherDEPT OF LABOR
SD57105R009OtherWPS TRICARE
IA0552638Medicaid
ND12976Medicaid
SD250267OtherMIDLANDS CHOICE
MN126H0WEOtherCC SYSTEMS/ BLUE PLUS
MN468669100Medicaid
SD4994112OtherBLUE CROSS
SDHP61153OtherHEALTHPARTNERS
SD6828650Medicaid
MN468669100Medicaid
SD4994112OtherBLUE CROSS
ND12976Medicaid