| Avera Medical Group Midwest Psychiatric Medicine Sioux Falls | |
|
4400 W 69th St Ste 500 Sioux Falls SD 57108 | |
| (605) 322-7580 | |
| (605) 322-7579 |
| Full Name | Avera Medical Group Midwest Psychiatric Medicine Sioux Falls |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4400 W 69th St, Sioux Falls, South Dakota |
| Authorized Official Name and Position | David Flicek (CEO/PRESIDENT) |
| Authorized Official Contact | 6053228000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Midwest Psychiatric Medicine Sioux Falls Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-7510 | Avera Medical Group Midwest Psychiatric Medicine Sioux Falls 4400 W 69th St Ste 500 Sioux Falls SD 57108 Ph: (605) 322-7580 |
| NPI Number | 1407829781 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 10/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407829781 | NPI | - | NPPES |
| 370624200 | Other | SD | DEPT OF LABOR |
| 3T021SC | Other | MN | BLUE PLUS |
| 65742 | Other | SD | HEALTHPARTNERS |
| 293011100 | Medicaid | MN | |
| 0006118 | Other | SD | BCBS |
| 92411422904 | Other | SD | PRIMEWEST |
| 0211607 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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