Provider Demographics
NPI:1538285739
Name:DAKOTA WOMEN'S CLINIC, MICHAEL R. KRAUSE, DO, PC
Entity Type:Organization
Organization Name:DAKOTA WOMEN'S CLINIC, MICHAEL R. KRAUSE, DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:605-990-1995
Mailing Address - Street 1:625 N FOSTER ST # 108
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-2969
Mailing Address - Country:US
Mailing Address - Phone:605-990-1995
Mailing Address - Fax:605-990-1839
Practice Address - Street 1:625 N FOSTER ST # 108
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-2969
Practice Address - Country:US
Practice Address - Phone:605-990-1995
Practice Address - Fax:605-990-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6200980Medicaid
SDH90947Medicare UPIN