Provider Demographics
NPI:1659075711
Name:CRITZER, SAM (MD-PHD)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:CRITZER
Suffix:
Gender:M
Credentials:MD-PHD
Other - Prefix:
Other - First Name:SAMUEL
Other - Middle Name:
Other - Last Name:CRITZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD-PHD
Mailing Address - Street 1:1212 S DUNHAM CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3318
Mailing Address - Country:US
Mailing Address - Phone:612-275-8370
Mailing Address - Fax:
Practice Address - Street 1:1400 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1570
Practice Address - Country:US
Practice Address - Phone:605-322-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program