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General NPI Number Information
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NPI Number | 1508590233
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Entity Type | Individual
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Provider Name | ALA WALEED BAKHEET ABUSHATTAL MD
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Gender | Female
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Dates
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Enumeration Date | 07/09/2022
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 2412 CUMING ST STE 200
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City | OMAHA
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State | NE
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Zip | 68131-1604
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Country | US
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Telephone | 402-717-0380
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Fax | 402-717-6059
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Provider Business Mailing Address
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Address Line | 2412 CUMING ST STE 200
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City | OMAHA
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State | NE
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Zip | 68131-1604
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Country | US
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Telephone | 402-717-0380
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Fax | 402-717-6059
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 36996
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License Number State | NE
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