Provider Demographics
NPI:1225186521
Name:INTERNAL MEDICINE PHYSICIANS P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE PHYSICIANS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:402-758-5800
Mailing Address - Street 1:17030 LAKESIDE HILLS PLZ
Mailing Address - Street 2:#102
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2396
Mailing Address - Country:US
Mailing Address - Phone:402-758-5800
Mailing Address - Fax:402-435-1404
Practice Address - Street 1:17030 LAKESIDE HILLS PLZ
Practice Address - Street 2:#102
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2396
Practice Address - Country:US
Practice Address - Phone:402-758-5800
Practice Address - Fax:402-435-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEDF6136OtherMEDICARE RAILROAD
NEDF6136OtherMEDICARE RAILROAD