Individual
KIM PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 S MARION RD, SIOUX FALLS, SD 57106
(605) 322-1010
(605) 322-1011
Mailing address
PO BOX 86430, SIOUX FALLS, SD 57118-6430
(605) 322-4900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1256
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5603282
—
SD
Enumeration date
06/18/2006
Last updated
05/15/2018
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