Provider Demographics
NPI:1750357299
Name:HUBER, MARK R (MD)
Entity type:Individual
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First Name:MARK
Middle Name:R
Last Name:HUBER
Suffix:
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 1:1000 E. 23RD ST.
Practice Address - Street 2:STE. 230
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2122
Practice Address - Country:US
Practice Address - Phone:605-322-6900
Practice Address - Fax:605-322-6901
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2013-12-12
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Provider Licenses
StateLicense IDTaxonomies
SD5612207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD4994628OtherBLUE CROSS
IA0593988Medicaid
MN146682800Medicaid
MN377G1HUOtherBLUE CROSS
SD6005140Medicaid
SD57105V007OtherWPS TRICARE
SDHP52503OtherHEALTHPARTNERS
MN377G1HUOtherCC SYSTEMS/ BLUE PLUS
MN92411422903OtherPRIMEWEST
SDP00269053OtherRR MEDICARE
SD3600589OtherMEDICA
SD5612OtherDAKOTACARE
SD2361646OtherARAZ/ AMERICA'S PPO
SD246830OtherMIDLANDS CHOICE
SD407191020165OtherPREFERRED ONE
SD370624200OtherDEPT OF LABOR
SD45374OtherSANFORD HEALTH PLAN
NE46022474336Medicaid
SD2361646OtherARAZ/ AMERICA'S PPO
SDH18767Medicare UPIN