Provider Demographics
NPI:1730107483
Name:MUNSTERMAN, CHAD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:MUNSTERMAN
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 1:3405 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-4417
Mailing Address - Country:US
Mailing Address - Phone:605-693-7222
Mailing Address - Fax:605-693-6614
Practice Address - Street 1:3405 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-4417
Practice Address - Country:US
Practice Address - Phone:605-693-7222
Practice Address - Fax:605-693-6614
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7604320Medicaid
SD0005377OtherBLUECROSS AND BLUE SHIELD
SD0005377OtherBLUECROSS AND BLUE SHIELD
SD7604320Medicaid