Healthcare Provider Details

I. General information

NPI: 1427206309
Provider Name (Legal Business Name): SHEILA DAWN GRIEVE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHEILA DAWN SMITH

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 5TH AVE STE 1
MITCHELL SD
57301
US

IV. Provider business mailing address

200 E 5TH AVE STE 1
MITCHELL SD
57301-2651
US

V. Phone/Fax

Practice location:
  • Phone: 605-990-5367
  • Fax: 605-990-5369
Mailing address:
  • Phone: 605-990-5367
  • Fax: 605-990-5369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number657
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: