Provider Demographics
NPI:1467537217
Name:MONASKY, MARK S (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:MONASKY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:ATTEN MEDICAL STAFF SERVICES
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6000
Mailing Address - Country:US
Mailing Address - Phone:605-719-7109
Mailing Address - Fax:605-719-1027
Practice Address - Street 1:2805 5TH ST
Practice Address - Street 2:100
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7306
Practice Address - Country:US
Practice Address - Phone:605-719-5700
Practice Address - Fax:605-719-5701
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2012-10-19
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Provider Licenses
StateLicense IDTaxonomies
ND6592207T00000X
SD5011207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDP00128449OtherRR MEDICARE
NDF62366Medicare UPIN