Individual
DR. BRENT J. LINDBLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5201
(605) 945-5094
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5201
(605) 945-5094
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1783
SD
207V00000X
Obstetrics & Gynecology Physician
Primary
SD1783
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6200540
—
SD
05
—
6200543
—
SD
Enumeration date
02/21/2006
Last updated
04/04/2012
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