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Individual

DR. THEKLA BACHARACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1305 W 18TH ST, SIOUX FALLS, SD 57105-0401
(605) 312-7300
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
LL37223
SC
2086S0129X
Vascular Surgery Physician
0116033191
VA
2086S0129X
Vascular Surgery Physician
Primary
11588
SD

Other

Enumeration date
06/19/2014
Last updated
10/26/2022
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