Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 23787 | NE |
NPI | 1003933128 |
---|---|
Provider Name | Dr. Cam E Enarson |
First Address | Omaha, NE 68178-0001 |
Second Address | Omaha, NE 68178-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B36561 | (02) | NE |