Healthcare Provider Details

I. General information

NPI: 1528355898
Provider Name (Legal Business Name): DANIEL ROBERT HECKMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981150 NEBRASKA MEDICAL CTR
OMAHA NE
68198-1150
US

IV. Provider business mailing address

1301 S 31ST ST APT. 5
OMAHA NE
68105-2066
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6602
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: