Provider Demographics
NPI:1831147149
Name:BURNAP, DONALD WEBSTER (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WEBSTER
Last Name:BURNAP
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 1:550 N 5TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-1375
Mailing Address - Country:US
Mailing Address - Phone:605-348-5400
Mailing Address - Fax:605-348-3241
Practice Address - Street 1:550 N 5TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1375
Practice Address - Country:US
Practice Address - Phone:605-348-5400
Practice Address - Fax:605-348-3241
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1005M2084P0800X, 2084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7100010Medicaid
SD0000678OtherBLUECROSS/BLUESHIELD
SDD28449Medicare UPIN
SD7100010Medicaid