| Avera Medical Group Gastroenterology Sioux Falls | |
|
6100 S Louise Ave Ste 3100 Sioux Falls SD 57108-6021 | |
| (605) 504-1400 | |
| Not Available |
| Full Name | Avera Medical Group Gastroenterology Sioux Falls |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 6100 S Louise Ave Ste 3100, 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 Gastroenterology Sioux Falls Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-7510 | Avera Medical Group Gastroenterology Sioux Falls 6100 S Louise Ave Ste 3100 Sioux Falls SD 57108-6021 Ph: (605) 504-1400 |
| NPI Number | 1194799882 |
|---|---|
| Provider Enumeration Date | 02/17/2006 |
| Last Update Date | 11/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194799882 | NPI | - | NPPES |
| 90876BA | Other | MN | BLUE PLUS |
| 92411422906 | Other | SD | PRIMEWEST |
| 90876BA | Other | MN | BCBS |
| 0530592 | Medicaid | IA | |
| 817930100 | Medicaid | MN | |
| 0006073 | Other | SD | BCBS |
| 370624200 | Other | SD | DEPT OF LABOR |
| 65737 | Other | SD | HEALTHPARTNERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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