Provider Demographics
NPI:1508976762
Name:ISAACSON, SHEILA M (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:ISAACSON
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:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:717 N 190TH PLZ STE 3100
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3988
Practice Address - Country:US
Practice Address - Phone:402-815-1335
Practice Address - Fax:402-815-2020
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21013208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025837400Medicaid
IA150897672Medicaid
NE47068731742Medicaid
IA150897672Medicaid