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General NPI Number Information
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NPI Number | 1093833840
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Entity Type | Organization
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Legal Business Name | MICHAEL R. PUUMALA, M.D.,P.C.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 911 E 20TH ST SUITE 400
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1042
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Country | US
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Telephone | 605-322-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 911 E 20TH ST SUITE 400
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1042
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Country | US
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Telephone | 605-322-8860
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | EDITH JORGENSEN
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Credential |
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Telephone | 605-322-8860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4116
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License Number State | SD
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