Provider Demographics
NPI:1750590998
Name:LAURICH, CHAD R (MD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:R
Last Name:LAURICH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N SIOUX POINT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5091
Mailing Address - Country:US
Mailing Address - Phone:605-217-5500
Mailing Address - Fax:605-217-5515
Practice Address - Street 1:345 W STEAMBOAT DR STE 601
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5287
Practice Address - Country:US
Practice Address - Phone:605-217-5617
Practice Address - Fax:605-217-5533
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230504082086S0129X
KS04-488912086S0129X
SD79602086S0129X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery