Provider Demographics
NPI:1881666485
Name:WIRTZ, PATRICIA S (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:WIRTZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1417 S. CLIFF AVE.
Practice Address - Street 2:STE. 401
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1064
Practice Address - Country:US
Practice Address - Phone:605-322-8920
Practice Address - Fax:605-322-8919
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD1148207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN040115001OtherPRIMEWEST
SD57105M002OtherWPS TRICARE
SDAH9131019111OtherPREFERRED ONE
SD0702891OtherMEDICA
SD370624200OtherDEPT. OF LABOR
MN704705300Medicaid
SD6200333Medicaid
SD1583OtherMIDLANDS CHOICE
IA1921171Medicaid
NE46022474316Medicaid
MN48D60WIOtherBLUE CROSS
SD0007995OtherBLUE CROSS
SD22143OtherSANFORD HEALTH PLANS
SD23564OtherARAZ/AMERICA'S PPO
MN48D60WIOtherCC SYSTEMS/ BLUE PLUS
SD1148OtherDAKOTACARE
MN151763OtherUCARE
SDHP24459OtherHEALTHPARTNERS
MN48D60WIOtherBLUE CROSS
MN48D60WIOtherCC SYSTEMS/ BLUE PLUS