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NPI Code Detail

MEDICARE: DR. THOMAS SCOTT STALDER M.D.

MEDICARE:  DR. THOMAS SCOTT STALDER  M.D.
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
1207RI0200XInfectious Disease Physician16935NE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1096555013OTHERNEMEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1861487829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS SCOTT STALDER M.D.
Provider Business Mailing Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3531
Fax Number : 402-413-3535
Provider Business Practice Location Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3531
Fax Number : 402-413-3535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 02/19/2015

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Directions to “ DR. THOMAS SCOTT STALDER M.D.” Practice Location

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