Provider Demographics
NPI:1881674547
Name:FROMM, STUART E (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:E
Last Name:FROMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7220 S HIGHWAY 16
Mailing Address - Street 2:PO BOX 6850
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8708
Mailing Address - Country:US
Mailing Address - Phone:605-341-1414
Mailing Address - Fax:605-341-7062
Practice Address - Street 1:7220 S HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8708
Practice Address - Country:US
Practice Address - Phone:605-341-1414
Practice Address - Fax:605-341-7062
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD4062207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1254560001OtherCIGNA MEDICARE
200028278OtherMEDICARE RAILROAD PTAN
SD6400910Medicaid
SD6400910Medicaid
SDS4958Medicare PIN