Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 1930 | SD |
NPI | 1467457549 |
---|---|
Provider Name | Michael M Fiegen |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-7702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 08/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6200504 | (05) | SD |
D25266 | (02) |