Organization
MEDICAL ASSOCIATES CLINIC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KERZMAN (BUSINESS OFFICE MANAGER)
(605) 224-5901
Entity
Organization
Contact information
Practice address
100 MAC LANE, PIERRE, SD 57501
(605) 224-5901
Mailing address
100 MAC LANE, P. O. BOX 758, PIERRE, SD 57501
(605) 224-5901
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000022
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/13/2006
Last updated
11/19/2008
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