Provider Demographics
NPI:1417951161
Name:VOLLSTEDT, KEITH A (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:VOLLSTEDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:705 N SIOUX POINT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5091
Mailing Address - Country:US
Mailing Address - Phone:605-217-5500
Mailing Address - Fax:605-217-5515
Practice Address - Street 1:705 N SIOUX POINT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5091
Practice Address - Country:US
Practice Address - Phone:605-217-5500
Practice Address - Fax:605-217-5515
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2010-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD3656208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery