Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 0951 | SD |
NPI | 1033627674 |
---|---|
Provider Name | Michael Wayne Pekas |
First Address | Sioux Falls, SD 57108-5237 |
Second Address | Sioux Falls, SD 57105-1305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2018 |
Last Update Date | 17/01/2018 |