Healthcare Provider Details
I. General information
NPI: 1013302413
Provider Name (Legal Business Name): EMERGENCY PHYSICIAN ASSOCIATES OF NEBRASKA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2015
Last Update Date: 04/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 N 30TH ST
OMAHA NE
68131-2128
US
IV. Provider business mailing address
307 S EVERGREEN AVE
WOODBURY NJ
08096-2739
US
V. Phone/Fax
- Phone: 402-449-4000
- Fax:
- Phone: 856-686-4316
- Fax: 865-291-3254
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
J
MURTAUGH
Title or Position: CFO
Credential:
Phone: 856-686-4316