Avera Medical Group Dermatology Mitchell

LBN: Avera Queen Of Peace
Avera Medical Group Dermatology Mitchell is an health care organization with primary practice located at 1900 Grassland Dr , Mitchell SD 57301-6205. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Avera Queen Of Peace can be contacted via phone (605) 995-7000, or through Ekeren, Douglas via phone (605) 668-8322.

Contact Information

Primary practice address
1900 Grassland Dr Mitchell SD 57301-6205
Phone: (605) 995-7000
Fax: (605) 995-7018
Website:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8322

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1881049484
LBN Legal business name Avera Queen Of Peace
DBA Doing business as Avera Medical Group Dermatology Mitchell
Authorized official Ekeren, Douglas
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2016
Last updated Aug 20th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881049484 NPPES
South Dakota Other S1639 MEDICARE PTAN

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