| Dr Marc E Boddicker, MD | |
|
710 Saint Anne St, Rapid City, SD 57701-4670 | |
| (605) 343-8000 | |
| (605) 341-8575 |
| Full Name | Dr Marc E Boddicker |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 710 Saint Anne St, Rapid City, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235103060 | NPI | - | NPPES |
| 41192855200 | Other | SD | NE MEDICAID |
| 070013291 | Other | SD | RR MEDICARE |
| 5900162 | Medicaid | SD |
| Entity Name | Advanced Dermatology Center, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346389178 PECOS PAC ID: 5294721775 Enrollment ID: O20040421000779 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Marc E Boddicker, MD Po Box 3468, Rapid City, SD 57709-3468 Ph: (605) 343-8000 | Dr Marc E Boddicker, MD 710 Saint Anne St, Rapid City, SD 57701-4670 Ph: (605) 343-8000 |
Tamara Poling, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701 Phone: 605-342-3280 | |
Dr. Heather Rae Peck, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2805 5th St Ste 210, Rapid City, SD 57701 Phone: 605-343-2267 | |
Dr. Linda Jo Fromm, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 4447 S Canyon Rd Ste 6, Rapid City, SD 57702 Phone: 605-721-5550 Fax: 605-721-5515 | |
Cynthia A Anderson, Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701 Phone: 605-721-8354 Fax: 605-721-8458 | |
Briana Hill, Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701 Phone: 605-342-3280 | |
Victoria Finley, Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2820 Mount Rushmore Rd, Rapid City, SD 57701 Phone: 605-342-3280 |