Healthcare Provider Details

I. General information

NPI: 1639864689
Provider Name (Legal Business Name): JULIAN YAHYA GHASSEMIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 31ST ST
KEARNEY NE
68847-2926
US

IV. Provider business mailing address

10 E 31ST ST
KEARNEY NE
68847-2926
US

V. Phone/Fax

Practice location:
  • Phone: 308-865-2690
  • Fax:
Mailing address:
  • Phone: 308-865-2690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number37284
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: