Individual
MARK E BUBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 W 49TH ST STE 104, SIOUX FALLS, SD 57105-6550
(605) 336-6385
(605) 336-6513
Mailing address
PO BOX 5126, SIOUX FALLS, SD 57117-5126
(605) 335-1952
(605) 373-9971
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
3512
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007519
BCBS
SD
05
—
1981852
—
IA
05
—
5900042
—
SD
01
—
73Q32BU
BCBS
MN
05
—
792302300
—
MN
Enumeration date
05/30/2006
Last updated
02/21/2013
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