Healthcare Provider Details

I. General information

NPI: 1861500696
Provider Name (Legal Business Name): DR. ALKA DESAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALKA BUECHLER

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13808 W MAPLE RD SUITE 100
OMAHA NE
68164-6231
US

IV. Provider business mailing address

8401 W DODGE RD SUITE 280
OMAHA NE
68114-3451
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-3000
  • Fax: 402-955-7055
Mailing address:
  • Phone: 402-955-6877
  • Fax: 402-955-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19797
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: