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NPI Code Detail

MEDICARE: NEBRASKA HEART INSTITUTE PC

MEDICARE: NEBRASKA HEART INSTITUTE PC
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
1207RC0001XClinical Cardiac Electrophysiology Physician
2207RI0011XInterventional Cardiology Physician
32086S0129XVascular Surgery Physician
4208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
5207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336125202
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEBRASKA HEART INSTITUTE PC
Provider Business Mailing Address
First Line : PO BOX 82585
Second Line :
City : LINCOLN
State : NE
Zip : 68501-2585
Country : US
Telephone Number : 402-489-6555
Fax Number : 402-328-3989
Provider Business Practice Location Address
First Line : 7440 SOUTH 91ST STREET
Second Line :
City : LINCOLN
State : NE
Zip : 68526-9797
Country : US
Telephone Number : 402-489-6555
Fax Number : 402-328-3989
Authorized Official
Title or Position : CONTROLLER
Name : MR. MARLIN AUSDEMORE
Credential :
Telephone Number : 402-328-3721
Provider Enumeration Date : 12/21/2005
Last Update Date : 08/11/2008

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1972523983 — HARPAUL BAJWA MD
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Directions to “NEBRASKA HEART INSTITUTE PC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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