Provider Demographics
NPI:1861408676
Name:ZIMPRICH, TODD A (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:ZIMPRICH
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 1:1301 S CLIFF AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1053
Mailing Address - Country:US
Mailing Address - Phone:605-335-0844
Mailing Address - Fax:605-977-1715
Practice Address - Street 1:1301 S CLIFF AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1053
Practice Address - Country:US
Practice Address - Phone:605-335-0844
Practice Address - Fax:605-977-1715
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD51222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0560334Medicaid
MN317T9ZIOtherBCBS
SD0040732OtherBCBS
IA0052543OtherBCBS
MN127727800Medicaid
SD6100860Medicaid
MN317T9ZIOtherBCBS
IAI20288Medicare PIN
MN127727800Medicaid
SDS40732Medicare PIN