Provider Demographics
NPI:1316050214
Name:RUSHMORE OB-GYN PC
Entity type:Organization
Organization Name:RUSHMORE OB-GYN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHMAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-343-7295
Mailing Address - Street 1:3006 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5392
Mailing Address - Country:US
Mailing Address - Phone:605-343-7295
Mailing Address - Fax:605-343-0138
Practice Address - Street 1:3006 TOWER RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5392
Practice Address - Country:US
Practice Address - Phone:605-343-7295
Practice Address - Fax:605-343-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4997309OtherBC/BS GROUP #
SD4997309OtherBC/BS GROUP #