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NPI Code Detail

MEDICARE: JEFFREY PATRICK MICHALAK DO

MEDICARE: JEFFREY PATRICK MICHALAK DO
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
1207RG0100XGastroenterology Physician933NE
2207RG0100XGastroenterology PhysicianDO-04307IA
3207RG0100XGastroenterology Physician8388SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962622431
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY PATRICK MICHALAK DO
Provider Business Mailing Address
First Line : 575 N SIOUX POINT ROAD
Second Line :
City : DAKOTA DUNES
State : SD
Zip : 57049-5312
Country : US
Telephone Number : 605-217-2667
Fax Number : 605-217-2900
Provider Business Practice Location Address
First Line : 575 N SIOUX POINT ROAD
Second Line :
City : DAKOTA DUNES
State : SD
Zip : 57049-5312
Country : US
Telephone Number : 605-217-2667
Fax Number : 605-217-2900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 12/10/2025

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Directions to “ JEFFREY PATRICK MICHALAK DO” Practice Location

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