Provider Demographics
NPI:1639353634
Name:WILLIAM M SULEIMAN MD PC
Entity Type:Organization
Organization Name:WILLIAM M SULEIMAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARCO
Authorized Official - Last Name:SULEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-865-7474
Mailing Address - Street 1:PO BOX 2258
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-2258
Mailing Address - Country:US
Mailing Address - Phone:308-865-7474
Mailing Address - Fax:308-865-2935
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-865-7474
Practice Address - Fax:308-865-2935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18515208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E93764Medicare UPIN