Healthcare Provider Details

I. General information

NPI: 1093804700
Provider Name (Legal Business Name): PAUL STEFFES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD
OMAHA NE
68124-2372
US

IV. Provider business mailing address

12508 WILLIAM ST
OMAHA NE
68144-1326
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-3636
  • Fax: 402-717-5050
Mailing address:
  • Phone: 402-333-4317
  • Fax: 402-717-5050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number12988
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: