Provider Demographics
NPI:1609840560
Name:PADEN, MICHAEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:PADEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069-1217
Mailing Address - Country:US
Mailing Address - Phone:605-624-9483
Mailing Address - Fax:605-624-9687
Practice Address - Street 1:26 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-1217
Practice Address - Country:US
Practice Address - Phone:605-624-9483
Practice Address - Fax:605-624-9687
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD986111N00000X
NE1349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0040464OtherWELLMARK PROVIDER NUMBER
SD22355OtherSIOUX VALLEY HEALTH NUM
SD6895OtherAVERA PROVIDER NUMBER
SD239569OtherMIDLANDS CHOICE NUMBER
SC7601530Medicaid
NE100252238-00Medicaid
NE100252238-00Medicaid
SC7601530Medicaid