Provider Demographics
NPI:1831105022
Name:MYSKIW, JOHN ERIC (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:MYSKIW
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11904 BUCK LN
Mailing Address - Street 2:
Mailing Address - City:CUSTER
Mailing Address - State:SD
Mailing Address - Zip Code:57730-7272
Mailing Address - Country:US
Mailing Address - Phone:605-517-9844
Mailing Address - Fax:
Practice Address - Street 1:BLACK HILLS HEALTHCARE
Practice Address - Street 2:113 COMANCHE RD
Practice Address - City:FORT MEADE
Practice Address - State:SD
Practice Address - Zip Code:57741
Practice Address - Country:US
Practice Address - Phone:605-347-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2024-12-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant