Provider Demographics
NPI:1508815945
Name:BIRKMANN, LEWISTON W (MD)
Entity Type:Individual
Prefix:
First Name:LEWISTON
Middle Name:W
Last Name:BIRKMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2631 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2960
Mailing Address - Country:US
Mailing Address - Phone:402-483-7226
Mailing Address - Fax:402-483-5440
Practice Address - Street 1:2631 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2960
Practice Address - Country:US
Practice Address - Phone:402-483-7226
Practice Address - Fax:402-483-5440
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE123322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB90941Medicare UPIN