Provider Demographics
NPI:1083656821
Name:STYS, ADAM TOMASZ (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:TOMASZ
Last Name:STYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-9419
Mailing Address - Fax:605-312-7611
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105
Practice Address - Country:US
Practice Address - Phone:605-328-2929
Practice Address - Fax:605-328-8429
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36676207RC0000X
SD4367207RC0000X, 207RI0011X
MN40610207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDP00471864Medicare PIN
MNP00692806Medicare PIN
MN060002469Medicare PIN
IAI20987Medicare PIN
SD060064071Medicare PIN
SDS101935Medicare PIN
SDS6845Medicare PIN
G71330Medicare UPIN
IAI20905Medicare PIN