Healthcare Provider Details

I. General information

NPI: 1710291257
Provider Name (Legal Business Name): EDWARD STEPHEN CHARTRAND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N 30TH ST
OMAHA NE
68131-2137
US

IV. Provider business mailing address

601 N 30TH ST
OMAHA NE
68131-2137
US

V. Phone/Fax

Practice location:
  • Phone: 402-449-4847
  • Fax: 402-449-4847
Mailing address:
  • Phone: 402-449-4847
  • Fax: 402-449-4885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number27668
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD-43114
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: