Healthcare Provider Details
I. General information
NPI: 1417912114
Provider Name (Legal Business Name): UNMC PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2006
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US
IV. Provider business mailing address
988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US
V. Phone/Fax
- Phone: 402-552-3739
- Fax:
- Phone: 402-552-3739
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
DAUBERT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 402-552-3739