Provider Demographics
NPI:1184295644
Name:MASIH, DURVA
Entity type:Individual
Prefix:DR
First Name:DURVA
Middle Name:
Last Name:MASIH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY ROAD, SUITE 202
Mailing Address - Street 2:CU DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124
Mailing Address - Country:US
Mailing Address - Phone:402-280-4392
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY ROAD, SUITE 202
Practice Address - Street 2:CU DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-280-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP9064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine