Individual
J MICHAEL BACHARACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Mailing address
4520 W 69TH ST, SIOUX FALLS, SD 57108-8148
(605) 977-5000
(605) 977-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3990
SD
2086S0129X
Vascular Surgery Physician
3990
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004040
SD BCBS
SD
01
—
03A41BA
MN BCBS - PLAN 91057NO
MN
05
—
0970046
—
IA
01
—
165023
UCARE
—
01
—
35693
HEALTH PARTNERS
—
01
—
3990
DAKOTACARE
SD
01
—
497L1BA
BCBS MN UNDER 538R2NO
MN
01
—
56195
IA BCBS #
IA
05
—
575892100
—
MN
05
—
6002910
—
SD
01
—
931451029029
PREFERRED ONE
—
Enumeration date
04/10/2006
Last updated
04/27/2020
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