Provider Demographics
NPI:1689726036
Name:MIDWEST CARDIOLOGY , P.C.
Entity Type:Organization
Organization Name:MIDWEST CARDIOLOGY , P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCI
Authorized Official - Middle Name:J
Authorized Official - Last Name:VIEYRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-978-5151
Mailing Address - Street 1:PO BOX 24825
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-0825
Mailing Address - Country:US
Mailing Address - Phone:402-978-5177
Mailing Address - Fax:402-341-3616
Practice Address - Street 1:8420 W DODGE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3443
Practice Address - Country:US
Practice Address - Phone:402-978-5177
Practice Address - Fax:402-341-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18952207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098939Medicare ID - Type UnspecifiedGROUP NUMBER