Provider Demographics
NPI:1639593395
Name:TELESFORD, NATASHA A (MD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:A
Last Name:TELESFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:353 FAIRMONT BLVD
Mailing Address - Street 2:ATTEN MSS
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7350
Mailing Address - Country:US
Mailing Address - Phone:605-755-8110
Mailing Address - Fax:605-755-1027
Practice Address - Street 1:502 E MONROE ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1400
Practice Address - Country:US
Practice Address - Phone:605-755-4060
Practice Address - Fax:605-755-4012
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2024-11-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD9422208M00000X
OH35124542208M00000X
MO2016040641207R00000X
KY48270208M00000X
NY327771208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH396540Medicare PIN