Basic Information
| Provider Information | |||||||||
| NPI: | 1811931637 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEBRASKA HOUSE CALL PHYSICIANS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 67250 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685067250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027306870 | ||||||||
| FaxNumber: | 4024206464 | ||||||||
| Practice Location | |||||||||
| Address1: | 3900 PINE LAKE RD | ||||||||
| Address2: | STE 5 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027306870 | ||||||||
| FaxNumber: | 8886584005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 07/18/2016 | ||||||||
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| AuthorizedOfficialLastName: | SATTAR | ||||||||
| AuthorizedOfficialFirstName: | ARIF | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4027306870 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 10025220500 | 05 | NE | MEDICAID | 01970 | 01 | NE | BCBS GROUP | OTHER | DD0249 | 01 | RRM | OTHER |