Healthcare Provider Details

I. General information

NPI: 1902530710
Provider Name (Legal Business Name): SUMA PUSAPATI MBBS/MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982265 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2265
US

IV. Provider business mailing address

982265 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2265
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-8888
  • Fax:
Mailing address:
  • Phone: 402-559-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10259
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: