Provider Demographics
NPI:1952408486
Name:SHIFFERMILLER, BILL A (MD)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:A
Last Name:SHIFFERMILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:WILLIAM
Other - Middle Name:A
Other - Last Name:SHIFFERMILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-2100
Mailing Address - Fax:402-354-2155
Practice Address - Street 1:16120 W DODGE RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-2049
Practice Address - Country:US
Practice Address - Phone:402-354-0550
Practice Address - Fax:402-354-0555
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47068731727Medicaid
IA1952408486Medicaid
NE47068731727Medicaid
IA1952408486Medicaid