Provider Demographics
NPI:1427369222
Name:VITAMVAS, JAMIE J (MD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:J
Last Name:VITAMVAS
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 1:7100 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2714
Mailing Address - Country:US
Mailing Address - Phone:402-506-9128
Mailing Address - Fax:402-315-2744
Practice Address - Street 1:7100 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2714
Practice Address - Country:US
Practice Address - Phone:402-506-9128
Practice Address - Fax:402-315-2744
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP6377207Q00000X
IA40569207Q00000X
NE26327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine