Organization
AVERA COLMAN MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN HOGAN (RN CLINIC MANAGER)
(605) 428-5446
Entity
Organization
Contact information
Practice address
109 N. MAIN, COLMAN, SD 57017
0
Mailing address
109 N. MAIN, COLMAN, SD 57017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4884
SD
207Q00000X
Family Medicine Physician
5054
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5610960
—
SD
05
—
5611290
—
SD
Enumeration date
01/08/2007
Last updated
08/22/2020
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