| Infectious Diseases Associates Pc | |
|
9202 W Dodge Rd Ste 203 Omaha NE 68114-3318 | |
| (402) 934-6504 | |
| (402) 934-6518 |
| Full Name | Infectious Diseases Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9202 W Dodge Rd Ste 203, Omaha, Nebraska |
| Authorized Official Name and Position | Karen L Pfeiffer (ADMINISTRATOR) |
| Authorized Official Contact | 4023548155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Associates Pc 9202 W Dodge Rd Ste 203 Omaha NE 68114-3318 Ph: (402) 934-6504 | Infectious Diseases Associates Pc 9202 W Dodge Rd Ste 203 Omaha NE 68114-3318 Ph: (402) 934-6504 |
| NPI Number | 1164448510 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 06/26/2024 |
| Medicare PECOS PAC ID | 5597663369 |
|---|---|
| Medicare Enrollment ID | O20031230000788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164448510 | NPI | - | NPPES |
| 0717280 | Medicaid | IA | |
| 07614 | Other | NE | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Robert G Penn |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013937374 PECOS PAC ID: 0547168312 Enrollment ID: I20100109000010 |
| Provider Name | Stacey A Shinaut |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811294515 PECOS PAC ID: 0749464758 Enrollment ID: I20110414000793 |
| Provider Name | Keri E Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093196909 PECOS PAC ID: 4284946294 Enrollment ID: I20150706001093 |
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