Basic Information
| Provider Information | |||||||||
| NPI: | 1386866325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEIREIS | ||||||||
| FirstName: | JEREMY | ||||||||
| MiddleName: | H. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 S 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571050900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6055045400 | ||||||||
| FaxNumber: | 6055045150 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 W 69TH ST | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571086418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053223455 | ||||||||
| FaxNumber: | 6053223456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 7596 | SD | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | R-7803 | IA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.