Healthcare Provider Details

I. General information

NPI: 1255063707
Provider Name (Legal Business Name): CALEB MORGAN HEDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981150 NEBRASKA MEDICAL CTR
OMAHA NE
68198-1150
US

IV. Provider business mailing address

77 NEALY AVE
LANGLEY AFB VA
23665-2040
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-6802
  • Fax:
Mailing address:
  • Phone: 757-764-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number36491
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101287032
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number9466
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: