Basic Information
| Provider Information | |||||||||
| NPI: | 1669576831 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEBRASKA EMERGENCY MEDICINE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 310457 | ||||||||
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| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503310457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668987142 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 SOUTH 48TH STREET | ||||||||
| Address2: | ER DEPT | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024890200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2006 | ||||||||
| LastUpdateDate: | 04/27/2021 | ||||||||
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| AuthorizedOfficialLastName: | MLINEK | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4024819049 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 04/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.