Provider Demographics
NPI:1629256888
Name:OMAHA HEART INSTITUTE PC
Entity Type:Organization
Organization Name:OMAHA HEART INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAYSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKKAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-559-3038
Mailing Address - Street 1:4239 FARNAM ST
Mailing Address - Street 2:#100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2868
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4239 FARNAM ST
Practice Address - Street 2:#100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2868
Practice Address - Country:US
Practice Address - Phone:402-559-3038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty