Provider Demographics
NPI:1720605223
Name:CHAISIDHIVEJ, NATAPAT (MD)
Entity Type:Individual
Prefix:
First Name:NATAPAT
Middle Name:
Last Name:CHAISIDHIVEJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:982000 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-2000
Mailing Address - Country:US
Mailing Address - Phone:402-559-4015
Mailing Address - Fax:402-559-7777
Practice Address - Street 1:982000 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3098
Practice Address - Country:US
Practice Address - Phone:402-559-4015
Practice Address - Fax:402-559-7777
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2023-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE9547207RG0100X
PAMT220532207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine