| Avera Medical Group Comprehensive Weight Management | |
|
911 E 20th St Ste 200 Sioux Falls SD 57105-1044 | |
| (605) 504-0400 | |
| (605) 504-0401 |
| Full Name | Avera Medical Group Comprehensive Weight Management |
|---|---|
| Speciality | Family Medicine - Obesity Medicine |
| Location | 911 E 20th St Ste 200, Sioux Falls, South Dakota |
| Authorized Official Name and Position | David William Flicek (PRESIDENT/CEO) |
| Authorized Official Contact | 6053227915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Medical Group Comprehensive Weight Management Po Box 86370 Sioux Falls SD 57118-6370 | Avera Medical Group Comprehensive Weight Management 911 E 20th St Ste 200 Sioux Falls SD 57105-1044 Ph: (605) 504-0400 |
| NPI Number | 1457096133 |
|---|---|
| Provider Enumeration Date | 04/28/2022 |
| Last Update Date | 04/28/2022 |
| Certification Date | 04/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457096133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QB0002X | Family Medicine - Obesity Medicine | () | Primary |
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