MEDICARE: SIOUX FALLS MENS WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1467300996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIOUX FALLS MENS WELLNESS PLLC

Provider Business Mailing Address
First Line	:	4908 E ROSA PARKS PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-4041
Country	:	US
Telephone Number	:	605-600-5454
Fax Number	:

Provider Business Practice Location Address
First Line	:	4908 E ROSA PARKS PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-4041
Country	:	US
Telephone Number	:	605-600-5454
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JEROD L WOLFF
Credential	:
Telephone Number	:	605-600-5454

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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