Individual
ELIZABETH DIMITRIEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
625 W 18TH ST, OBGYN SPECIALTY CLINIC, SIOUX FALLS, SD 57105
(605) 338-0836
(605) 338-7890
Mailing address
625 W 18TH ST, OBGYN SPECIALTY CLINIC, SIOUX FALLS, SD 57105
(605) 338-0836
(605) 338-7890
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
3478
SD
207VX0000X
Obstetrics Physician
2018041689
MO
207VX0000X
Obstetrics Physician
Primary
T3072
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6200662
—
SD
Enumeration date
07/18/2006
Last updated
08/24/2023
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