Organization
AVERA ST. LUKE'S
Active
Other names
Avera Medical Group Selby
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE STREIER (VICE PRESIDENT)
(605) 622-2807
Entity
Organization
Contact information
Practice address
4401 MAIN ST, SELBY, SD 57472
(605) 649-9999
(605) 946-9987
Mailing address
PO BOX 1460, ABERDEEN, SD 57402-1460
(605) 622-2857
(605) 622-2859
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6153
WELLMARK BC/BS OF SD
SD
Enumeration date
07/13/2006
Last updated
04/02/2020
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