Provider Demographics
NPI:1316230063
Name:CARNEY, SERI ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SERI
Middle Name:ANN
Last Name:CARNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SERI
Other - Middle Name:ANN
Other - Last Name:AAMLID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57101-0820
Mailing Address - Country:US
Mailing Address - Phone:605-940-7583
Mailing Address - Fax:712-478-4086
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:605-333-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SD10075207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MN050002617Medicare PIN