Basic Information
| Provider Information | |||||||||
| NPI: | 1548479231 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEYFER | ||||||||
| FirstName: | DAISHA | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SEYFER | ||||||||
| OtherFirstName: | DAISHA | ||||||||
| OtherMiddleName: | L | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1105 W RUSSELL ST | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571041322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6052712690 | ||||||||
| FaxNumber: | 6052713956 | ||||||||
| Practice Location | |||||||||
| Address1: | 3820 JACKSON BLVD STE 2 | ||||||||
| Address2: | |||||||||
| City: | RAPID CITY | ||||||||
| State: | SD | ||||||||
| PostalCode: | 577023249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6052712690 | ||||||||
| FaxNumber: | 6052713956 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 02/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 208000000X | 35093460 | OH | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0006X | 8323 | SD | Y | Allopathic & Osteopathic Physicians | Pediatrics | Developmental – Behavioral Pediatrics |
No ID Information.