Individual
JONATHAN S BLEEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1309 W 17TH ST, STE 101, SIOUX FALLS, SD 57104-4663
(605) 328-8000
(605) 328-8001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101244302
VA
207RH0003X
Hematology & Oncology Physician
104308
MN
207RH0003X
Hematology & Oncology Physician
52164
MN
207RH0003X
Hematology & Oncology Physician
Primary
8325
SD
390200000X
Student in an Organized Health Care Education/Training Program
0116017474
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457573974
—
VA
05
—
ENROLLED
—
MN
01
—
P00813442
RAILROAD MEDICARE
MN
Enumeration date
05/03/2007
Last updated
04/29/2022
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