Healthcare Provider Details

I. General information

NPI: 1477505410
Provider Name (Legal Business Name): ROWEN K ZETTERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

988095 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8095
US

IV. Provider business mailing address

988095 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8095
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-9800
  • Fax: 402-559-9840
Mailing address:
  • Phone: 402-559-9800
  • Fax: 402-559-9840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number11976
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: