Organization
MIDWEST EAR, NOSE & THROAT ASSOCIATES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE D SNOOZY (BUSINESS OFFICE MANAGER)
(605) 275-1211
Entity
Organization
Contact information
Practice address
2315 W 57TH ST, SIOUX FALLS, SD 57108
(605) 336-3503
(605) 336-6010
Mailing address
2315 W 57TH ST, SIOUX FALLS, SD 57108-5046
(605) 336-3503
(605) 336-6010
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
271R7MI
BLUE SHIELD
MN
01
—
4996180
BLUE SHIELD
SD
05
—
504101500
—
MN
01
—
9214052
DAKOTACARE
SD
Enumeration date
04/19/2006
Last updated
01/18/2023
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