Provider Demographics
NPI:1144292848
Name:GAETZE, VERONICA JANE (MD)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:JANE
Last Name:GAETZE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 86370
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57118-6370
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1417 S. CLIFF AVE.
Practice Address - Street 2:STE. 401
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1064
Practice Address - Country:US
Practice Address - Phone:605-322-8920
Practice Address - Fax:605-322-8919
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD1765207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1511121Medicaid
SD160055444OtherRR MEDICARE
SD25927OtherSANFORD HEALTH PLANS
SD6200443Medicaid
IA33581,33582,33583OtherBLUE CROSS
SD9315OtherMIDLANDS CHOICE
MN047T8GAOtherCC SYSTEMS/ BLUE PLUS
SDHP28269OtherHEALTHPARTNERS
SD0008502OtherBLUE CROSS
NE46022474316Medicaid
SD0702557OtherMEDICA
SD1765OtherDAKOTACARE
MN521590100Medicaid
SD790189OtherARAZ/ AMERICA'S PPO
SD57105M003OtherWPS TRICARE
MN492S1GA/ 047T8GAOtherBLUE CROSS
SDAH9131019048OtherPREFERRED ONE
MN492S1GA/ 047T8GAOtherBLUE CROSS
IA33581,33582,33583OtherBLUE CROSS
MN521590100Medicaid