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General NPI Number Information
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NPI Number | 1225957707
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Entity Type | Organization
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Legal Business Name | PRAESIDIUM MEDICAL LLC
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 200 S 21ST ST STE 400A
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City | LINCOLN
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State | NE
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Zip | 68510-1044
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Country | US
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Telephone | 816-668-8771
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Fax |
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Provider Business Mailing Address
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Address Line | 9661 HEATHER LN
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City | MANHATTAN
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State | KS
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Zip | 66502-1884
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Country | US
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Telephone | 816-668-8771
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBERT JAMES NOVAK
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Credential | DO
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Telephone | 816-668-8771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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