Provider Demographics
NPI:1558523134
Name:PATEL, EMILY MARIE (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:PIERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2797
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-2797
Mailing Address - Country:US
Mailing Address - Phone:402-354-4230
Mailing Address - Fax:402-354-6171
Practice Address - Street 1:717 N 190TH PLZ
Practice Address - Street 2:SUITE 2400
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-3913
Practice Address - Country:US
Practice Address - Phone:402-815-1970
Practice Address - Fax:402-815-1595
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29242207V00000X
IA43581207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026473700Medicaid
NE10026485700Medicaid
NE47037660416Medicaid
IA1558523134Medicaid
NE086403009Medicare PIN
IAIB3635009Medicare PIN