Healthcare Provider Details

I. General information

NPI: 1548479231
Provider Name (Legal Business Name): DAISHA L. SEYFER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAISHA L SEYFER MD

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 JACKSON BLVD STE 2
RAPID CITY SD
57702-3249
US

IV. Provider business mailing address

1105 W RUSSELL ST
SIOUX FALLS SD
57104-1322
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-2690
  • Fax: 605-271-3956
Mailing address:
  • Phone: 605-271-2690
  • Fax: 605-271-3956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35093460
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number8323
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: