| Avera Medical Group Health Care Clinic Sioux Falls | |
|
300 N Dakota Ave. Ste. 117 Sioux Falls SD 57104-6020 | |
| (605) 322-6800 | |
| (605) 322-6802 |
| Full Name | Avera Medical Group Health Care Clinic Sioux Falls |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 N Dakota Ave., 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 Health Care Clinic Sioux Falls Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-7510 | Avera Medical Group Health Care Clinic Sioux Falls 300 N Dakota Ave. Ste. 117 Sioux Falls SD 57104-6020 Ph: (605) 322-6800 |
| NPI Number | 1083894067 |
|---|---|
| Provider Enumeration Date | 11/07/2007 |
| Last Update Date | 10/24/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083894067 | NPI | - | NPPES |
| 30B74GU | Other | SD | BLUE PLUS |
| 57105F001 | Other | SD | TRICARE |
| 12262 | Medicaid | ND | |
| 0006020 | Other | SD | BLUE CROSS OF SOUTH DAKOT |
| 0532341 | Medicaid | IA | |
| 30B74GU | Other | MN | BLUE CROSS |
| 59767 | Other | SD | HEALTHPARTNERS |
| 068417100 | Medicaid | MN | |
| 9251873 | Other | SD | DAKOTACARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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