MEDICARE: SURGICAL CARE 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
1	174400000X	Specialist	15659	NE

General Provider Information

NPI Number	:	1487848321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL CARE PC

Provider Business Mailing Address
First Line	:	2221 S 17TH ST
Second Line	:	SUITE 303
City	:	LINCOLN
State	:	NE
Zip	:	68502-3782
Country	:	US
Telephone Number	:	402-476-6626
Fax Number	:	402-476-1614

Provider Business Practice Location Address
First Line	:	2221 S 17TH ST
Second Line	:	SUITE 303
City	:	LINCOLN
State	:	NE
Zip	:	68502-3782
Country	:	US
Telephone Number	:	402-476-6626
Fax Number	:	402-476-1614

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD J WINDLE
Credential	:	M.D.
Telephone Number	:	402-476-6626

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	04/20/2008

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