| Michelle Lee Daffer, MD | |
|
575 N Sioux Point Road, Dakota Dunes, SD 57049-5312 | |
| (605) 217-2667 | |
| (605) 217-2900 |
| Full Name | Michelle Lee Daffer |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 26 Years |
| Location | 575 N Sioux Point Road, Dakota Dunes, South Dakota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396711867 | NPI | - | NPPES |
| 000166004 | Other | SD | RR MEDICARE |
| I12538 | Other | IA | MEDICAID |
| 0442046 | Other | IA | MEDICARE |
| 5900470 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 5461 (South Dakota) | Primary |
| 207N00000X | Dermatology | MD-35711 (Iowa) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Regional Medical Center | Sioux city, IA | Hospital |
| Buena Vista Regional Medical Center | Storm lake, IA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cnos Pc | 4284548942 | 97 |
| Cnos Pc | 4284548942 | 97 |
| Entity Name | Cnos Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881604320 PECOS PAC ID: 4284548942 Enrollment ID: O20031217000907 |
| Entity Name | Midlands Clinic Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649364894 PECOS PAC ID: 8820981681 Enrollment ID: O20040205000255 |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Lee Daffer, MD 575 N Sioux Point Road, Dakota Dunes, SD 57049-5312 Ph: (605) 217-2667 | Michelle Lee Daffer, MD 575 N Sioux Point Road, Dakota Dunes, SD 57049-5312 Ph: (605) 217-2667 |
Raymond Takashi Kuwahara, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 575 N Sioux Point Road, Dakota Dunes, SD 57049 Phone: 605-217-2667 Fax: 605-217-2900 | |
Mrs. Katie Evelyn Shull, ARNP Dermatology Medicare: Accepting Medicare Assignments Practice Location: 330 Dakota Dunes Blvd Ste 400, Dakota Dunes, SD 57049 Phone: 605-422-3000 |