Provider Demographics
NPI:1952660011
Name:ALTHAUS, ADAM BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:BENJAMIN
Last Name:ALTHAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:455 N SIOUX POINT RD
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5327
Mailing Address - Country:US
Mailing Address - Phone:605-217-7000
Mailing Address - Fax:605-217-7015
Practice Address - Street 1:455 N SIOUX POINT RD
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5327
Practice Address - Country:US
Practice Address - Phone:605-217-7000
Practice Address - Fax:605-217-7015
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD11185208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology