Provider Demographics
NPI:1164448510
Name:INFECTIOUS DISEASES ASSOCIATES PC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASES ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-354-8155
Mailing Address - Street 1:8111 DODGE ST
Mailing Address - Street 2:SUITE 363
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4119
Mailing Address - Country:US
Mailing Address - Phone:402-354-8155
Mailing Address - Fax:402-354-8159
Practice Address - Street 1:8111 DODGE ST
Practice Address - Street 2:SUITE 363
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4119
Practice Address - Country:US
Practice Address - Phone:402-354-8155
Practice Address - Fax:402-354-8159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE07614OtherBCBS
IA0717280Medicaid
NE=========13Medicaid
NE097069Medicare PIN
IA0717280Medicaid