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NPI Code Detail

MEDICARE: CENTER FOR FAMILY MEDICINE

MEDICARE: CENTER FOR FAMILY MEDICINE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164493672
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR FAMILY MEDICINE
Provider Business Mailing Address
First Line : 1115 E 20TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-1013
Country : US
Telephone Number : 605-339-1783
Fax Number : 605-367-7157
Provider Business Practice Location Address
First Line : 1115 E 20TH ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-1013
Country : US
Telephone Number : 605-339-1783
Fax Number : 605-367-7157
Authorized Official
Title or Position : BUSINESS OFFICE SUPERVISOR
Name : ROSE MARIE FEDT
Credential :
Telephone Number : 605-575-1608
Provider Enumeration Date : 02/01/2006
Last Update Date : 05/23/2023

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Directions to “CENTER FOR FAMILY MEDICINE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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