Healthcare Provider Details

I. General information

NPI: 1376514398
Provider Name (Legal Business Name): LEE DAVID WILLIAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6902 PINE ST
OMAHA NE
68106-2855
US

IV. Provider business mailing address

985450 NEBRASKA MEDICAL CTR
OMAHA NE
68198-5450
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-6418
  • Fax: 402-559-5737
Mailing address:
  • Phone: 402-559-5753
  • Fax: 402-559-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36823
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number36823
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: