Provider Demographics
NPI:1417994104
Name:FIKSINSKI, MAGDALENA M (MD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:M
Last Name:FIKSINSKI
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 1:10170 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2174
Mailing Address - Country:US
Mailing Address - Phone:402-391-3800
Mailing Address - Fax:402-391-2422
Practice Address - Street 1:10170 NICHOLAS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2174
Practice Address - Country:US
Practice Address - Phone:402-391-3800
Practice Address - Fax:402-391-2422
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154613207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47083181713Medicaid
NE098941001Medicare PIN