Healthcare Provider Details

I. General information

NPI: 1629219712
Provider Name (Legal Business Name): HEART LUNG AND VASCULAR SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 03/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD SUITE 420
OMAHA NE
68124-2372
US

IV. Provider business mailing address

7710 MERCY RD SUITE 420
OMAHA NE
68124-2372
US

V. Phone/Fax

Practice location:
  • Phone: 402-393-6700
  • Fax: 402-393-1098
Mailing address:
  • Phone: 402-393-6700
  • Fax: 402-393-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number18180
License Number StateNE

VIII. Authorized Official

Name: DR. STEVEN JOHN FELDHAUS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-393-6700