Provider Demographics
NPI:1619457868
Name:DUFANI, JALAL MOHAMED (MD)
Entity Type:Individual
Prefix:
First Name:JALAL
Middle Name:MOHAMED
Last Name:DUFANI
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 1:7500 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:402-398-5822
Mailing Address - Fax:402-398-5589
Practice Address - Street 1:CREIGHTON UNIVERSITY INTERNAL MEDICINE
Practice Address - Street 2:7710 MERCY ROAD, SUITE 202
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-6812
Practice Address - Country:US
Practice Address - Phone:402-637-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine