Provider Demographics
NPI:1588612642
Name:SANIUK, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SANIUK
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 1:2206 LONGO DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-2977
Mailing Address - Country:US
Mailing Address - Phone:402-292-9170
Mailing Address - Fax:402-292-0119
Practice Address - Street 1:2206 LONGO DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2977
Practice Address - Country:US
Practice Address - Phone:402-292-9170
Practice Address - Fax:402-292-0119
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB67877Medicare UPIN