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Organization
AVERA ST. LUKE'S
Active
Organization
AVERA ST. LUKE'S
Active
Other names
Avera Medical Group Selby
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE STREIER (VICE PRESIDENT)
(605) 622-2807
Entity
Organization
Contact information
Practice address
4401 MAIN ST, SELBY, SD 57472
(605) 649-9999
(605) 946-9987
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2857
(605) 622-2859
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6153
WELLMARK BC/BS OF SD
SD
Enumeration date
07/13/2006
Last updated
04/02/2020
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