Provider Demographics
NPI:1942421516
Name:PRESTBO, AARON A (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:A
Last Name:PRESTBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-0900
Mailing Address - Country:US
Mailing Address - Phone:605-504-5400
Mailing Address - Fax:605-504-5150
Practice Address - Street 1:1910 W 69TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5612
Practice Address - Country:US
Practice Address - Phone:605-322-5200
Practice Address - Fax:605-322-5205
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2022-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SD7276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5613120Medicaid
S102698Medicare PIN