Provider Demographics
NPI:1760420194
Name:FINNEGAN, MARY T (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:T
Last Name:FINNEGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7911 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3104
Mailing Address - Country:US
Mailing Address - Phone:402-390-0333
Mailing Address - Fax:402-390-9632
Practice Address - Street 1:7911 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3104
Practice Address - Country:US
Practice Address - Phone:402-390-0333
Practice Address - Fax:402-390-9632
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
I04388Medicare UPIN
279756Medicare PIN