Healthcare Provider Details

I. General information

NPI: 1669553202
Provider Name (Legal Business Name): MADELEINE MACDONALD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E 29TH ST
FREMONT NE
68025
US

IV. Provider business mailing address

750 E 29TH ST
FREMONT NE
68025
US

V. Phone/Fax

Practice location:
  • Phone: 402-753-2900
  • Fax: 402-753-2926
Mailing address:
  • Phone: 402-753-2900
  • Fax: 402-753-2926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: