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Organization

MIDWEST STREET MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON EMRY MD (MEDICAL DIRECTOR)
(605) 370-3054
Entity
Organization

Contact information

Practice address
701 E 8TH ST, SIOUX FALLS, SD 57103-1632
(605) 334-6732
Mailing address
605 S NICHOLAS CIR, BRANDON, SD 57005-1162

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
207RN0300X
Nephrology Physician
208000000X
Pediatrics Physician
208D00000X
General Practice Physician
261QP2300X
Primary Care Clinic/Center
Primary
363A00000X
Physician Assistant
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
07/24/2024
Last updated
08/28/2024
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