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General NPI Number Information
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NPI Number | 1659414597
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Entity Type | Organization
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Legal Business Name | MIDWEST ALLERGY AND ASTHMA CLINIC, P.C.
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 16945 FRANCES ST
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City | OMAHA
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State | NE
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Zip | 68130-2312
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Country | US
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Telephone | 402-397-7400
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Fax | 402-397-0115
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Provider Business Mailing Address
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Address Line | 16945 FRANCES ST
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City | OMAHA
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State | NE
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Zip | 68130-2312
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Country | US
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Telephone | 402-397-7400
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Fax | 402-397-0115
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | STEVEN WHITE
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Credential |
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Telephone | 402-397-7455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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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 | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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