| NPI | 1427003946 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP WAUBAY |
| Entity Type | Organization |
| Authorized Contact | DAVID FLICEK President/CEO 605-322-7916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 0317) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-09-10 |