Healthcare Provider Details

I. General information

NPI: 1023258795
Provider Name (Legal Business Name): HAYSAM AKKAD, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 07/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4239 FARNAM ST #100
OMAHA NE
68131-2868
US

IV. Provider business mailing address

4239 FARNAM ST #100
OMAHA NE
68131-2868
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2320
  • Fax: 402-552-2330
Mailing address:
  • Phone: 402-552-2320
  • Fax: 402-552-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HAYSAM AKKAD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-552-2320