Provider Demographics
NPI:1033132451
Name:EDINGER, DARLA (MD)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:EDINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 N FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-2966
Mailing Address - Country:US
Mailing Address - Phone:605-995-5701
Mailing Address - Fax:605-995-5700
Practice Address - Street 1:525 N FOSTER ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-2966
Practice Address - Country:US
Practice Address - Phone:605-995-5701
Practice Address - Fax:605-995-5700
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3965207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD3965OtherDAKOTA CARE
SD0007853OtherWELLMARK BCBS
SD080179430OtherRAILROAD MEDICARE
SDS1639OtherMEDICARE PTAN
SDF66308Medicare UPIN
SD6002746Medicare ID - Type Unspecified
SD0007853OtherWELLMARK BCBS