Organization
DAKOTA EAR NOSE & THROAT CLINIC
Active
Organization
DAKOTA EAR NOSE & THROAT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD R SHAKER MD (PRESIDENT DAKOTA ENT CLINIC PC)
(605) 353-6575
Entity
Organization
Contact information
Practice address
172 4TH ST SE, STE 401, HURON, SD 57350
(605) 353-6575
(605) 353-6576
Mailing address
172 4TH ST SE, STE 401, HURON, SD 57350
(605) 353-6575
(605) 353-6576
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
48503020
WI
207Y00000X
Otolaryngology Physician
Primary
5227
SD
207Y00000X
Otolaryngology Physician
8429
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022505
WELLMARK
—
05
—
6520350
—
SD
01
—
9213433
DAKOTA CARE
—
Enumeration date
11/16/2006
Last updated
08/22/2020
Update your record
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