Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 30140 | NE |
NPI | 1619107851 |
---|---|
Provider Name | Douglas Alan Stoller |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-7708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2009 |
Last Update Date | 17/03/2018 |