MEDICARE: TAMARA LYNN VIK M.D.

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
1	2084P0804X	Child & Adolescent Psychiatry Physician	5452	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	246829	OTHER	SD	MIDLANDS CHOICE
2	370624200	OTHER	SD	DEPT OF LABOR
3	412991044655	OTHER	SD	PREFERRED ONE
4	5452	OTHER	SD	DAKOTACARE
5	57108C030	OTHER	SD	WPS TRICARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	2361645	OTHER	SD	ARAZ/ AMERICA'S PPO
8	28971	OTHER	SD	SANFORD HEALTH PLAN
9	HP54601	OTHER	SD	HEALTHPARTNERS
10	4994771	OTHER	SD	BLUE CROSS
11	548K1VI	OTHER	MN	CC SYSTEMS/ BLUE PLUS
12	040121002	OTHER	MN	PRIMEWEST
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548233091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA LYNN VIK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 86370
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57118-6370
Country	:	US
Telephone Number	:	605-322-7510
Fax Number	:	605-322-6475

Provider Business Practice Location Address
First Line	:	4400 W 69TH ST
Second Line	:	STE 1500
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-8170
Country	:	US
Telephone Number	:	605-322-5700
Fax Number	:	605-322-5704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	10/11/2018

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