Vizcarra, Dale E

Vizcarra, Dale E is an individual health care provider with primary practice located at 100 Mac Lane Avera Medical Group Pierre, Pierre SD 57501. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Vizcarra, Dale E can be contacted via phone (605) 224-5901.

Contact Information

Primary practice address
100 Mac Lane Avera Medical Group Pierre Pierre SD 57501
Phone: (605) 224-5901
Fax: (605) 945-5096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3600 South Dakota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X SD3600 South Dakota

Profile Details

NPI number 1992768469
LBN Legal business name Vizcarra, Dale E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Apr 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992768469 NPPES
South Dakota MEDICAID 5609172
South Dakota MEDICAID 5609170

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