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General NPI Number Information
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NPI Number | 1659568475
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Entity Type | Organization
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Legal Business Name | MASEK INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 2627 STOCKWELL ST
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City | LINCOLN
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State | NE
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Zip | 68502-5755
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Country | US
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Telephone | 402-421-2225
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Fax | 402-421-2242
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Provider Business Mailing Address
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Address Line | 2627 STOCKWELL ST
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City | LINCOLN
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State | NE
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Zip | 68502-5755
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Country | US
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Telephone | 402-421-2225
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Fax | 402-421-2242
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SHARON K MCGINN
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Credential |
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Telephone | 402-421-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 16187
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License Number State | NE
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