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General NPI Number Information
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NPI Number | 1922042456
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Entity Type | Individual
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Provider Name | MARK EDWARD KREMEN MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 10824 OLD MILL RD #21
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City | OMAHA
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State | NE
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Zip | 68154-2642
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Country | US
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Telephone | 402-330-6060
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Fax | 402-330-6108
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Provider Business Mailing Address
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Address Line | 6617 CUMING ST
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City | OMAHA
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State | NE
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Zip | 68132-1121
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Country | US
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Telephone | 402-981-5507
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Fax | 402-932-6024
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21643
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35135
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License Number State | IA
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