MEDICARE: LIANE E DONOVAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0401X	Addiction Medicine (Internal Medicine) Physician	19455	NE
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	19455	NE

General Provider Information

NPI Number	:	1093770687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANE E DONOVAN MD

Provider Business Mailing Address
First Line	:	4130 PIONEER WOODS DR STE 4
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-7552
Country	:	US
Telephone Number	:	402-858-0117
Fax Number	:	402-477-9295

Provider Business Practice Location Address
First Line	:	4130 PIONEER WOODS DR STE 4
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-7552
Country	:	US
Telephone Number	:	402-858-0117
Fax Number	:	402-477-9295

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/16/2023

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Directions to “ LIANE E DONOVAN MD” Practice Location

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