Organization · NPI-2
Berg Medical Clinic PC
Family Medicine · De Smet, SD
NPI number1770767782
StatusActive
Last updated in NPPESJan 3, 2008
Details
- NPI
- 1770767782
- Entity type
- Organization (NPI-2)
- Legal business name
- Berg Medical Clinic PC
- Organization subpart
- No
- Enumeration date
- Dec 27, 2007
- Last updated
- Jan 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | SD 4247 | SD | Yes |
Practice location
221 Calumet Ave SwDe Smet, SD 57231
Phone 605-854-9100 · Fax 605-854-9238
Mailing address
221 Calumet Ave SwDe Smet, SD 57231
Phone 605-854-9100 · Fax 605-854-9238
Authorized official
Janelle Schubloom
Office Manager
6058549100
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