Healthcare Provider Details

I. General information

NPI: 1013066315
Provider Name (Legal Business Name): MALINDA J BENDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 SHANNON DR
BELLEVUE NE
68133-4711
US

IV. Provider business mailing address

4802 SHANNON DR
BELLEVUE NE
68133-4711
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-7605
  • Fax: 402-955-7601
Mailing address:
  • Phone: 402-955-7605
  • Fax: 402-955-7601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27243
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: