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Organization
LIEM SOM OEI MD PC
Active
Organization
LIEM SOM OEI MD PC
Active
Other names
Renal Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
TERI HARRIS (OFFICE MANAGER)
(712) 255-7746
Entity
Organization
Contact information
Practice address
357 W TOWER RD, DAKOTA DUNES, SD 57049-5018
(712) 255-7746
(712) 255-0829
Mailing address
357 W TOWER RD, DAKOTA DUNES, SD 57049-5018
(712) 255-7746
(712) 255-0829
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028951
—
IA
01
—
02895
WELLMARK
IA
01
—
098555
NEBRASKA MEDICARE PTAN
—
01
—
CI7806
RAILROAD MEDICARE
—
01
—
S108150
SOUTH DAKOTA PTAN
SD
Enumeration date
05/25/2006
Last updated
07/21/2022
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