Healthcare Provider Details

I. General information

NPI: 1700862810
Provider Name (Legal Business Name): JOSEPH CHARLES CAMARATA M.D., D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S 16TH ST SUITE 300
LINCOLN NE
68502-3796
US

IV. Provider business mailing address

2222 S 16TH ST SUITE 300
LINCOLN NE
68502-3796
US

V. Phone/Fax

Practice location:
  • Phone: 402-435-0044
  • Fax: 402-435-7010
Mailing address:
  • Phone: 402-435-0044
  • Fax: 402-435-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number20444
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: