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Individual

ERIC ANDREW BANNWARTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1210 W 18TH ST, STE G01, SIOUX FALLS, SD 57104-4651
(605) 328-2663
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0805
SD
363A00000X
Physician Assistant
NC

Other

Enumeration date
09/15/2011
Last updated
04/18/2022
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