Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 7322 | NE |
NPI | 1477968659 |
---|---|
Provider Name | Abhishek Challa |
First Address | Omaha, NE 68198-3285 |
Second Address | Omaha, NE 68198-3285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 25/06/2014 |