Provider Demographics
NPI:1467457549
Name:FIEGEN, MICHAEL M (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:FIEGEN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:STE 510
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6585
Mailing Address - Fax:605-328-6512
Practice Address - Street 1:1500 W 22ND ST
Practice Address - Street 2:STE 402
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-7702
Practice Address - Country:US
Practice Address - Phone:605-328-8750
Practice Address - Fax:605-328-8751
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2018-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD1930207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6200504Medicaid
SDS42263Medicare PIN
SD6200504Medicaid
SD160059474Medicare PIN