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AVERA QUEEN OF PEACE NPI 1346671492


NPI Information

NPI: 1346671492
Provider Name: AVERA QUEEN OF PEACE

Doing Business As: AVERA MEDICAL GROUP UROLOGY MITCHELL

Classification: Urology - 208800000X
Entity Type: Organization
Address:
1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301
Phone: (605) 995-7000
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AVERA QUEEN OF PEACE is an urology in Mitchell, SD. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. AVERA QUEEN OF PEACE NPI is 1346671492. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Urology Mitchell.

The provider's business location address is:

1900 GRASSLAND DR
MITCHELL, SD
ZIP 57301-205
Phone: (605) 995-7000

The provider's authorized official is Douglas Ekeren .
The authorized official title is President/ceo and has the following contact phone number (605) 668-8322.

The enumeration date for this NPI number is 11/27/2013 and was last updated on 8/20/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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