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Organization

AVERA MCKENNAN

Active
Other names
Avera Medical Group Hematology, Transplant & Cellular Therapy Sioux Fa
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID FLICEK (CEO/PRESIDENT)
(605) 322-8000
Entity
Organization

Contact information

Practice address
1000 E. 23RD ST., STE. 200, SIOUX FALLS, SD 57105-2122
(605) 322-3035
(605) 322-3036
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007442
BCBS
SD
05
0573931
IA
05
306918400
MN
01
370624200
DEPT OF LABOR
SD
01
68B91LE
BCBS
MN
01
71664
HEALTHPARTNERS
SD
01
9174731
DAKOTACARE
SD
01
92411422911
PRIMEWEST
MN
Enumeration date
02/28/2006
Last updated
01/18/2021
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