Provider Demographics
NPI:1285686212
Name:WEST, MADELINE J (MD)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:J
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:402-552-6006
Mailing Address - Fax:402-552-6225
Practice Address - Street 1:988102 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-8102
Practice Address - Country:US
Practice Address - Phone:402-552-6006
Practice Address - Fax:402-552-6225
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE194842084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557539Medicaid
NE47078557539Medicaid
NE269784Medicare ID - Type Unspecified