MEDICARE: STEPHEN J ACKERMAN MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	21011	NE
2	207RC0000X	Cardiovascular Disease Physician	21011	NE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1538149257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN J ACKERMAN MD

Provider Business Mailing Address
First Line	:	7440 S 91ST ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9797
Country	:	US
Telephone Number	:	402-489-6555
Fax Number	:	402-328-3770

Provider Business Practice Location Address
First Line	:	7440 S 91ST ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68526-9797
Country	:	US
Telephone Number	:	402-489-6555
Fax Number	:	402-328-3770

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	10/17/2012

7440 SOUTH 91ST STREET
LINCOLN, NE
68526-9797

Practice Phone: 402-489-6555
Practice Fax: 402-328-3989