| NPI | 1285689646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK E BUBAK Provider 605-336-6385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: SD 0348) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2013-02-21 |