# AVERA QUEEN OF PEACE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Internal Medicine Delaney Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861740151
- **Authorized official:** DOUGLAS EKEREN (PRESIDENT/CEO)
- **Authorized official phone:** (605) 668-8322

## Contact information

- **Practice address:** 1115 E 5TH AVE, MITCHELL, SD 57301-2917
- **Practice address phone:** (605) 996-5553
- **Mailing address:** 1115 E 5TH AVE, MITCHELL, SD 57301-2917
- **Mailing address phone:** (605) 996-5553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |

## Other

- **Enumeration date:** 08/17/2012
- **Last updated:** 08/20/2020