Provider Demographics
NPI:1376709808
Name:ABOEATA, AHMED SALAH AHMED
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:SALAH AHMED
Last Name:ABOEATA
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:
Other - Last Name:ABOEATA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBCH
Mailing Address - Street 1:7500 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EMILE 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-0001
Practice Address - Country:US
Practice Address - Phone:402-559-8888
Practice Address - Fax:402-559-3060
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5772207R00000X
NE26574207RC0000X
IA39908207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine