Ellender, Michael Scott

Ellender, Michael Scott is an individual health care provider with primary practice located at 1601 Mount Rushmore Rd Suite 5, Rapid City SD 57701-4588. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ellender, Michael Scott can be contacted via phone (605) 348-7401.

Contact Information

Primary practice address
1601 Mount Rushmore Rd Suite 5 Rapid City SD 57701-4588
Phone: (605) 348-7401
Fax: (605) 348-9773
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T573 South Dakota

Profile Details

NPI number 1245301787
LBN Legal business name Ellender, Michael Scott
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Oct 4th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1245301787 NPPES
South Dakota MEDICAID 9201210

Popular Providers