Provider Demographics
NPI:1154486306
Name:CHUGHTAI, WASIM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WASIM
Middle Name:W
Last Name:CHUGHTAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2222 S 16TH ST
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3796
Mailing Address - Country:US
Mailing Address - Phone:402-483-8590
Mailing Address - Fax:402-483-8599
Practice Address - Street 1:6900 VAN DORN ST
Practice Address - Street 2:SUITE 24
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2882
Practice Address - Country:US
Practice Address - Phone:402-489-3200
Practice Address - Fax:402-489-5101
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2021-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE19785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0400302OtherUHC
NE10026311700Medicaid
NE1714OtherBCBS
NE470812081OtherTAX ID
NE080124010OtherRAILROAD MEDICARE
NE47081208100Medicaid
NE470812081OtherCOMMERCIAL INS
NE270498Medicare PIN
NE0400302OtherUHC
NE080124010OtherRAILROAD MEDICARE