Provider Demographics
NPI:1043390578
Name:KLAWITTER, ELIZABETH MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MARIE
Last Name:KLAWITTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11071 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-2604
Mailing Address - Country:US
Mailing Address - Phone:402-315-4344
Mailing Address - Fax:402-315-4343
Practice Address - Street 1:11071 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-2604
Practice Address - Country:US
Practice Address - Phone:402-315-4344
Practice Address - Fax:402-315-4343
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE280213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10024973600Medicaid
NE02516OtherBCBS ID #
NE421572165OtherMIDLANDS CHOICE ID #
NE2700248OtherUHC ID #
NE5076470001OtherDMERC ID #
NE02516OtherBCBS ID #
NEU86379Medicare UPIN