Healthcare Provider Details

I. General information

NPI: 1629256888
Provider Name (Legal Business Name): OMAHA HEART INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2008
Last Update Date: 02/09/2008
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: 402-559-3038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HAYSAM AKKAD
Title or Position: PRESIDENT
Credential: MD
Phone: 402-559-3038