Organization
LIEM SOM OEI MD PC
Active
Other names
Renal Associates PC
Organization subpart
No
Provider details
NPI number
Authorized official
TERI HARRIS (OFFICE MANAGER)
(712) 255-7746
Entity
Organization
Contact information
Practice address
357 W TOWER RD, DAKOTA DUNES, SD 57049-5018
(712) 255-7746
(712) 255-0829
Mailing address
357 W TOWER RD, DAKOTA DUNES, SD 57049-5018
(712) 255-7746
(712) 255-0829
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028951
—
IA
01
—
02895
WELLMARK
IA
01
—
098555
NEBRASKA MEDICARE PTAN
—
01
—
CI7806
RAILROAD MEDICARE
—
01
—
S108150
SOUTH DAKOTA PTAN
SD
Enumeration date
05/25/2006
Last updated
07/21/2022
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