Healthcare Provider Details

I. General information

NPI: 1508446964
Provider Name (Legal Business Name): ADAM R BLEEKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 S MINNESOTA AVE
SIOUX FALLS SD
57108-2563
US

IV. Provider business mailing address

6601 S MINNESOTA AVE
SIOUX FALLS SD
57108-2563
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-6294
  • Fax:
Mailing address:
  • Phone: 605-336-6294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number18504
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: