Individual
DR. DALE E VIZCARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-5901
(605) 945-5096
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 224-5901
(605) 945-5096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3600
SD
207Q00000X
Family Medicine Physician
Primary
SD3600
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5609170
—
SD
05
—
5609172
—
SD
Enumeration date
04/07/2006
Last updated
04/27/2012
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