Organization
AVERA ST. LUKE'S
Active
Other names
Avera Medical Group Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J BJERKNES (PRESIDENT/CEO)
(605) 622-5125
Entity
Organization
Contact information
Practice address
310 S PENN ST STE 203, ABERDEEN, SD 57401-4553
(605) 622-2570
(605) 622-2571
Mailing address
PO BOX 860674, MINNEAPOLIS, MN 55486-0001
(605) 622-2570
(605) 622-2571
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14712
—
ND
01
—
9255744
DAKOTACARE
SD
Enumeration date
02/07/2008
Last updated
08/18/2022
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