Provider Demographics
NPI:1588624142
Name:MAJERUS, JOHN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:MAJERUS
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 1:3201 PIONEERS BLVD.
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502
Mailing Address - Country:US
Mailing Address - Phone:402-483-2987
Mailing Address - Fax:402-483-2981
Practice Address - Street 1:3201 PIONEERS BLVD.
Practice Address - Street 2:SUITE 304
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502
Practice Address - Country:US
Practice Address - Phone:402-483-2987
Practice Address - Fax:402-483-2981
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00980831OtherMEDICARE RAILROAD
NE10026101700Medicaid
NENA1941004OtherMEDICARE PTAN
NENA1941004OtherMEDICARE PTAN
H27932Medicare UPIN
NE6604160001Medicare NSC