| NPI | 1821686932 |
|---|---|
| Doing Business As | AVERA MEDICAL GROUP PEDIATRIC CRITICAL CARE SERVICES |
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-01-05 |