Provider Demographics
NPI:1336184977
Name:SINUCARE SD PC
Entity Type:Organization
Organization Name:SINUCARE SD PC
Other - Org Name:SETLIFF SINUS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SETLIFF
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:605-339-1872
Mailing Address - Street 1:2709 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4016
Mailing Address - Country:US
Mailing Address - Phone:605-339-1872
Mailing Address - Fax:605-339-3872
Practice Address - Street 1:2709 E 26TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4016
Practice Address - Country:US
Practice Address - Phone:605-339-1872
Practice Address - Fax:605-339-3872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3904207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0004986OtherBCBS - GROUP
WY121999500Medicaid
WY121999500Medicaid
SDS4986Medicare PIN