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General NPI Number Information
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NPI Number | 1629256888
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Entity Type | Organization
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Legal Business Name | OMAHA HEART INSTITUTE PC
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Dates
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Enumeration Date | 02/09/2008
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Last Update Date | 02/09/2008
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Provider Practice Location Address
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Address Line | 4239 FARNAM ST #100
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City | OMAHA
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State | NE
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Zip | 68131-2868
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Country | US
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Telephone | 402-559-3038
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Fax |
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Provider Business Mailing Address
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Address Line | 4239 FARNAM ST #100
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City | OMAHA
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State | NE
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Zip | 68131-2868
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAYSAM AKKAD
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Credential | MD
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Telephone | 402-559-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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