Provider Demographics
NPI:1427111749
Name:SACHS, STEVEN D (PA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:SACHS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 JACKSON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-3497
Mailing Address - Country:US
Mailing Address - Phone:605-341-1208
Mailing Address - Fax:605-341-3552
Practice Address - Street 1:2822 JACKSON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3497
Practice Address - Country:US
Practice Address - Phone:605-341-1208
Practice Address - Fax:605-341-3552
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD0407363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0001972OtherWELLMARK
SD6826190Medicaid
SD0001972OtherWELLMARK
SDS5808Medicare PIN