Provider Demographics
NPI:1548479231
Name:SEYFER, DAISHA L (MD)
Entity type:Individual
Prefix:DR
First Name:DAISHA
Middle Name:L
Last Name:SEYFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAISHA
Other - Middle Name:L
Other - Last Name:SEYFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1105 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1322
Mailing Address - Country:US
Mailing Address - Phone:605-271-2690
Mailing Address - Fax:605-271-3956
Practice Address - Street 1:3820 JACKSON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3249
Practice Address - Country:US
Practice Address - Phone:605-271-2690
Practice Address - Fax:605-271-3956
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OH35093460208000000X
SD83232080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No208000000XAllopathic & Osteopathic PhysiciansPediatrics