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Organization
AVERA MCKENNAN
Active
Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Hematology, Transplant & Cellular Therapy Sioux Fa
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FLICEK (CEO/PRESIDENT)
(605) 322-8000
Entity
Organization
Contact information
Practice address
1000 E. 23RD ST., STE. 200, SIOUX FALLS, SD 57105-2122
(605) 322-3035
(605) 322-3036
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007442
BCBS
SD
05
—
0573931
—
IA
05
—
306918400
—
MN
01
—
370624200
DEPT OF LABOR
SD
01
—
68B91LE
BCBS
MN
01
—
71664
HEALTHPARTNERS
SD
01
—
9174731
DAKOTACARE
SD
01
—
92411422911
PRIMEWEST
MN
Enumeration date
02/28/2006
Last updated
01/18/2021
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