Provider Demographics
NPI:1346296639
Name:NORLIN, ROLF A (MD)
Entity Type:Individual
Prefix:MR
First Name:ROLF
Middle Name:A
Last Name:NORLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 SAINT CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-4530
Mailing Address - Country:US
Mailing Address - Phone:605-721-0942
Mailing Address - Fax:
Practice Address - Street 1:914 SAINT CHARLES ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-4530
Practice Address - Country:US
Practice Address - Phone:605-718-5127
Practice Address - Fax:605-388-4621
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDG75899Medicare UPIN
SDG75899Medicare UPIN