Provider Demographics
NPI:1134230758
Name:FAHMY, LYLIA M (MD)
Entity type:Individual
Prefix:
First Name:LYLIA
Middle Name:M
Last Name:FAHMY
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 1:4951 CENTER ST STE 206
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3252
Mailing Address - Country:US
Mailing Address - Phone:402-933-7247
Mailing Address - Fax:402-933-7196
Practice Address - Street 1:4951 CENTER ST STE 206
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3252
Practice Address - Country:US
Practice Address - Phone:402-933-7247
Practice Address - Fax:402-933-7196
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36383207V00000X
NE23205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE03908OtherBCBSN
0701259OtherSHARE ADVANTAGE-S. 24TH
IA4473371Medicaid
NE10025907600Medicaid
NE42150546520Medicaid
0701260OtherSHARE ADVANTAGE-LAKESIDE
0701261OtherSHARE ADVANTAGE-HARLAN
NE45490OtherBCBS OF NEBRASKA
94341OtherCENTER
94346OtherWELLMARK-S. 24TH
IA0473371Medicaid
0701258OtherSHARE ADVANTAGE-CENTER
NE42150546516Medicaid
NE42150546517Medicaid
IA5473371Medicaid
NE248479OtherMIDLANDS CHOICE
0701288OtherSHARE ADVANTAGE-1 EDMUNDS
0701259OtherSHARE ADVANTAGE-S. 24TH
IA0473371Medicaid
94341OtherCENTER
NE45490OtherBCBS OF NEBRASKA
IAI16655Medicare ID - Type Unspecified
NENA1716001Medicare PIN