Healthcare Provider Details

I. General information

NPI: 1740109677
Provider Name (Legal Business Name): AVERA ST LUKE'S
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 S PENN ST STE 203
ABERDEEN SD
57401-4553
US

IV. Provider business mailing address

PO BOX 360452
PITTSBURGH PA
15250-6452
US

V. Phone/Fax

Practice location:
  • Phone: 605-622-2895
  • Fax:
Mailing address:
  • Phone: 605-622-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J BJERKNES
Title or Position: REGIONAL PRESIDENT & CEO
Credential:
Phone: 605-622-5230