Healthcare Provider Details

I. General information

NPI: 1609096205
Provider Name (Legal Business Name): PAUL M. BRUEGGEMAN AU.D. CCC-A, FAAA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 S LOUISE AVE STE 208
SIOUX FALLS SD
57106-3124
US

IV. Provider business mailing address

4300 S LOUISE AVE STE 208
SIOUX FALLS SD
57106-3124
US

V. Phone/Fax

Practice location:
  • Phone: 605-929-3273
  • Fax:
Mailing address:
  • Phone: 605-929-3273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number28
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number28
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number28
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number28
License Number StateSD
# 5
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: