Healthcare Provider Details

I. General information

NPI: 1124017256
Provider Name (Legal Business Name): MICHAEL STEPHEN MCHALE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E. 23RD ST. STE. 230
SIOUX FALLS SD
57105-2122
US

IV. Provider business mailing address

PO BOX 86370
SIOUX FALLS SD
57118-6370
US

V. Phone/Fax

Practice location:
  • Phone: 605-322-6900
  • Fax: 605-322-6901
Mailing address:
  • Phone: 605-322-7510
  • Fax: 605-322-6475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number1762
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: