Healthcare Provider Details
I. General information
NPI: 1215976147
Provider Name (Legal Business Name): DOUGLAS ROBERT FIEDLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 S 48TH ST SUITE 800
LINCOLN NE
68506-1276
US
IV. Provider business mailing address
1500 S 48TH ST STE 800
LINCOLN NE
68506-1200
US
V. Phone/Fax
- Phone: 402-483-8600
- Fax: 402-483-8689
- Phone: 402-483-8600
- Fax: 402-483-8689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | 23729 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | L3642 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | 23729 |
| License Number State | NE |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 23729 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: