Provider Demographics
NPI:1790717809
Name:STOVER, ROBERT DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:STOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 70TH ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2469
Mailing Address - Country:US
Mailing Address - Phone:402-488-2225
Mailing Address - Fax:866-863-3407
Practice Address - Street 1:301 S 70TH ST
Practice Address - Street 2:SUITE 250
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2469
Practice Address - Country:US
Practice Address - Phone:402-488-2225
Practice Address - Fax:866-863-3407
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36602OtherBLUE CROSS BLUE SHIELD
NE5778OtherMIDLANDS CHOICE
NE44-00066OtherUNITED HEALTHCARE
NE85280OtherCOVENTRY
NE099596OtherMEDICARE
NE20-3833606OtherFEDERAL ID NUMBER
NE85280OtherCOVENTRY
NEPENDINGMedicare ID - Type Unspecified