Healthcare Provider Details

I. General information

NPI: 1427028547
Provider Name (Legal Business Name): MILTON CHARLES ZADINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 11/08/2021
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 38TH ST
COLUMBUS NE
68601-1616
US

IV. Provider business mailing address

PO BOX 1394
COLUMBUS NE
68602-1394
US

V. Phone/Fax

Practice location:
  • Phone: 402-564-1338
  • Fax: 402-564-8902
Mailing address:
  • Phone: 402-564-1338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15263
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: