Provider Demographics
NPI:1578536728
Name:TERSTRIEP, SHELBY A (MD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:A
Last Name:TERSTRIEP
Suffix:
Gender:F
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:
Mailing Address - Fax:
Practice Address - Street 1:820 4 STREET NORTH
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:NC
Practice Address - Zip Code:58122
Practice Address - Country:US
Practice Address - Phone:701-234-2397
Practice Address - Fax:701-234-3861
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN44845207RH0003X
ND10689207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0T949TEOtherMN BCBS
1052299OtherPREFERREDONE
ND14402Medicaid
ND28864OtherND BCBS
3600840OtherMEDICA
MN350433600Medicaid
HEALTHPARTNERSOtherHP62138
ND28864OtherND BCBS
NDN713020Medicare PIN
1052299OtherPREFERREDONE
MN110239144Medicare ID - Type UnspecifiedRAILROAD