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Individual

MICHAEL ADERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
S DAKOTA STATE UNIVERSITY, 2820 HPER CENTER, BROOKINGS, SD 57007-1497
(605) 688-4003
Mailing address
S DAKOTA STATE UNIVERSITY, 2820 HPER CENTER, BROOKINGS, SD 57007-1497
(605) 688-4003

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0001259
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0482
SDBMOE
SD
01
2000013908
BOC
Enumeration date
03/09/2015
Last updated
08/01/2015
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