Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 7256 | MN |
Y | 207VE0102X | Reproductive Endocrinologist | CP001729 | SD |
N | 207VE0102X | Reproductive Endocrinologist | F157868 | IA |
NPI | 1336772128 |
---|---|
Provider Name | Amanda Tilberg |
First Address | Sioux Falls, SD 57103-0214 |
Second Address | Sioux Falls, SD 57105-1503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 21/02/2020 |