Provider Demographics
NPI:1447222906
Name:KANNAN, HARI D (MD)
Entity Type:Individual
Prefix:
First Name:HARI
Middle Name:D
Last Name:KANNAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6709 S MINNESOTA AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2593
Mailing Address - Country:US
Mailing Address - Phone:605-322-7516
Mailing Address - Fax:605-322-7519
Practice Address - Street 1:911 E 20TH ST
Practice Address - Street 2:STE. 403
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1042
Practice Address - Country:US
Practice Address - Phone:605-322-7516
Practice Address - Fax:605-322-7519
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2020-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD34862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7100862Medicaid
SDF00653Medicare UPIN
SD7420Medicare ID - Type Unspecified