MEDICARE: SHUANGJIANG DU

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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1447974803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHUANGJIANG DU

Provider Business Mailing Address
First Line	:	6221 S 58TH ST STE F
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-3679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6221 S 58TH ST STE F
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68516-3679
Country	:	US
Telephone Number	:	555-555-5555
Fax Number	:

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

Provider Enumeration Date	:	09/29/2022
Last Update Date	:	06/23/2023

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Directions to “ SHUANGJIANG DU ” Practice Location

Language	Start Address	Practice Location

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