Provider Demographics
NPI:1548478118
Name:AREND, DAVID CHARLES (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:AREND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 69TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2403
Mailing Address - Country:US
Mailing Address - Phone:605-336-0635
Mailing Address - Fax:
Practice Address - Street 1:201 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2403
Practice Address - Country:US
Practice Address - Phone:605-336-0635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.009446208800000X
SD7262208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1548478118Medicaid
MN1548478118Medicaid
SD1548478118OtherBCBS
MN1548478118OtherBCBS
SD7500530Medicaid
SD1548478118OtherBCBS
MN1548478118OtherBCBS