Provider Demographics
NPI:1235426032
Name:SVETANOFF, WENDY JO (MD)
Entity Type:Individual
Prefix:
First Name:WENDY JO
Middle Name:
Last Name:SVETANOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N 30TH ST
Mailing Address - Street 2:CREIGHTON UNIVERSITY - DEPARTMENT OF SURGERY
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2137
Mailing Address - Country:US
Mailing Address - Phone:402-280-4464
Mailing Address - Fax:402-280-3446
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:CREIGHTON UNIVERSITY - DEPARTMENT OF SURGERY
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2137
Practice Address - Country:US
Practice Address - Phone:402-280-4464
Practice Address - Fax:402-280-3446
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE6544208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery