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Individual

MARY G JAHRAUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-7070
(605) 224-2514

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0228
SD
363A00000X
Physician Assistant
Primary
228
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3820713
SD
05
6820710
SD
Enumeration date
06/01/2006
Last updated
04/13/2012
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