Provider Demographics
NPI:1558575498
Name:SCHIRBER, SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:SCHIRBER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 3RD ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7374
Mailing Address - Country:US
Mailing Address - Phone:605-341-2000
Mailing Address - Fax:605-719-3211
Practice Address - Street 1:2800 3RD ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7374
Practice Address - Country:US
Practice Address - Phone:605-341-2000
Practice Address - Fax:605-719-3211
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLD2984000152W00000X
SD645152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4992665OtherWELLMARK
SD9203792Medicaid
SD9253095OtherDAKOTACARE
SD4992666OtherWELLMARK
SD9203793Medicaid
SD410044841Medicare PIN
SD9253095OtherDAKOTACARE
SD410044835Medicare PIN
SD9203792Medicaid
SD4992665OtherWELLMARK
SD9203793Medicaid