Provider Demographics
NPI:1568492833
Name:WELCH, SCOTT D (CRNA)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:WELCH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5045
Mailing Address - Street 2:PAT FINANCIAL SERVICES
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5045
Mailing Address - Country:US
Mailing Address - Phone:605-322-6400
Mailing Address - Fax:605-322-6499
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-2754
Practice Address - Fax:605-322-2727
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SDR021511367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDP00883878OtherRAILROAD MEDICARE
NE460224743-48Medicaid
MN050K3WEOtherMN BLUECROSS BS
SD5752363Medicaid
IA1120378Medicaid
SDR021011OtherDAKOTACARE
SD0065181OtherBLUE CROSS OF SD
SD5752364Medicaid
MN634243400Medicaid
SDS40674Medicare PIN
SDR021011OtherDAKOTACARE
SD5752363Medicaid