Healthcare Provider Details

I. General information

NPI: 1518178680
Provider Name (Legal Business Name): SHIRLEY FENELONNE DELAIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PEDIATRIC INFECTIOUS DISEASES 982162 NEBRASKA MEDICAL CENTER
OMAHA NE
68198-2162
US

IV. Provider business mailing address

8200 DODGE ST
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-4005
  • Fax: 402-955-3948
Mailing address:
  • Phone: 402-955-4005
  • Fax: 402-955-3849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number25777
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: