Provider Demographics
NPI:1265408728
Name:AWADALLAH, SAMI M (MD)
Entity type:Individual
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First Name:SAMI
Middle Name:M
Last Name:AWADALLAH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2400 S. MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1417 S. CLIFF AVE
Practice Address - Street 2:STE. 010
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1014
Practice Address - Country:US
Practice Address - Phone:605-322-3666
Practice Address - Fax:605-322-3665
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2013-12-19
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Provider Licenses
StateLicense IDTaxonomies
SD34462080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE46022474339Medicaid
MN276575600Medicaid
SD370624200OtherDEPT OF LABOR
SD7958OtherMIDLANDS CHOICE
IA1976670Medicaid
SD6002362Medicaid
SD722801028065OtherPREFERRED ONE
SD0008229OtherBLUE CROSS
MN034T5AWOtherBLUE CROSS
MN034T5AWOtherCC SYSTEMS/ BLUE PLUS
ND13414Medicaid
SD370019670OtherRR MEDICARE
SD24237OtherARAZ/ AMERICA'S PPO
SD24981OtherSANFORD HEALTH PLAN
SD3446OtherDAKOTACARE
SD2500708OtherMEDICA
SD57105I003OtherWPS TRICARE
SDHP24496OtherHEALTHPARTNERS
MN034T5AWOtherBLUE CROSS
SD370624200OtherDEPT OF LABOR