Basic Information
Provider Information
NPI: 1508037920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHIMELPFENIG
FirstName: SAMUEL
MiddleName: SEAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 S 7TH AVE
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571050900
CountryCode: US
TelephoneNumber: 6057828305
FaxNumber: 6053361677
Practice Location
Address1: 1200 S 7TH AVE
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571050900
CountryCode: US
TelephoneNumber: 6053362140
FaxNumber: 6053361677
Other Information
ProviderEnumerationDate: 03/13/2008
LastUpdateDate: 04/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XSD8028SDY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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