Provider Demographics
NPI:1598977886
Name:EMBURY, STUART PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:PAUL
Last Name:EMBURY
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 1:1606 GARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1422
Mailing Address - Country:US
Mailing Address - Phone:308-995-4053
Mailing Address - Fax:
Practice Address - Street 1:1606 GARFIELD DR
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1422
Practice Address - Country:US
Practice Address - Phone:308-995-4053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB-67553Medicare UPIN
NE272672Medicare ID - Type Unspecified