Individual
TAREK H MAHROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
7205
SD
207RI0011X
Interventional Cardiology Physician
Primary
7205
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07327
BCBS
NE
05
—
1553412
—
IA
01
—
236601
MIDLAND'S CHOICE
NE
01
—
25-02714
MEDICA
—
05
—
46036096612
—
NE
05
—
470780857 23
—
NE
05
—
6005810
—
SD
01
—
7205
DAKOTACARE
SD
01
—
89-00057
UHC
NE
Enumeration date
08/03/2006
Last updated
10/05/2022
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