Provider Demographics
NPI:1972529915
Name:BIGNER, DORI RENE'
Entity Type:Individual
Prefix:DR
First Name:DORI
Middle Name:RENE'
Last Name:BIGNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-1016
Mailing Address - Country:US
Mailing Address - Phone:605-322-8000
Mailing Address - Fax:605-322-8414
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-8000
Practice Address - Fax:605-322-8414
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5359207R00000X, 208M00000X
IA33646207R00000X
MT10024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0269514Medicaid
IA17725OtherMEDICARE ID
MT1972529915Medicaid
SD6004790Medicaid
IA110244492OtherMEDICARE RAILROAD
IA110244492OtherMEDICARE RAILROAD
MT1972529915Medicaid