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1780635730

NPI Code Detail

MEDICARE: LANCE E SCHUPBACH MD

MEDICARE: LANCE E SCHUPBACH 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	207R00000X	Internal Medicine Physician	21885	NE
2	208M00000X	Hospitalist Physician	21885	NE

Other Identifiers

#	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

General Provider Information

NPI Number	:	1780635730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANCE E SCHUPBACH MD

Provider Business Mailing Address
First Line	:	PO BOX 6971
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-0971
Country	:	US
Telephone Number	:	402-421-1811
Fax Number	:	402-421-1833

Provider Business Practice Location Address
First Line	:	2300 S 16TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68502-3704
Country	:	US
Telephone Number	:	402-475-1011
Fax Number	:	402-481-4783

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	01/07/2014

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Directions to “ LANCE E SCHUPBACH MD” Practice Location

Language	Start Address	Practice Location

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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