Provider Demographics
NPI:1578569000
Name:BEHREND, ROBERT D (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:BEHREND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-7180
Mailing Address - Fax:605-328-7177
Practice Address - Street 1:1205 S GRANGE AVE
Practice Address - Street 2:STE 510
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0410
Practice Address - Country:US
Practice Address - Phone:605-328-7500
Practice Address - Fax:605-328-7599
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6002622Medicaid
SD110227608Medicare PIN
SD6002622Medicaid
3588Medicare UPIN
SDF31764Medicare UPIN
SDS8261Medicare PIN
SDS4551Medicare PIN
SD8261Medicare PIN