Healthcare Provider Details

I. General information

NPI: 1003044793
Provider Name (Legal Business Name): ABHISHEK SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FNU ABHISHEK MB;BS

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 N 72ND ST
OMAHA NE
68122-1709
US

IV. Provider business mailing address

1125 S 103RD ST STE 800
OMAHA NE
68124-6018
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-0070
  • Fax:
Mailing address:
  • Phone: 347-551-0572
  • Fax: 402-829-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number32420
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number32420
License Number StateNE

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1003044793
Identifier TypeMEDICAID
Identifier StateMI
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: