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General NPI Number Information
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NPI Number | 1740109677
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Entity Type | Organization
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Legal Business Name | AVERA ST LUKE'S
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Dates
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Enumeration Date | 07/14/2026
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Last Update Date | 07/14/2026
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Provider Practice Location Address
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Address Line | 310 S PENN ST STE 203
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City | ABERDEEN
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State | SD
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Zip | 57401-4553
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Country | US
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Telephone | 605-622-2895
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 360452
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City | PITTSBURGH
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State | PA
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Zip | 15250-6452
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Country | US
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Telephone | 605-622-2895
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Fax |
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Authorized Official
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Title or Position | REGIONAL PRESIDENT & CEO
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Name | DANIEL J BJERKNES
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Credential |
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Telephone | 605-622-5230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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