Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 128755 | NC |
N | 208600000X | Surgeon | 128755 | NC |
Y | 2086X0206X | Surgical Oncologist | 28765 | NE |
NPI | 1457528028 |
---|---|
Provider Name | Dr. James Constantine Padussis |
First Address | Omaha, NE 68198-0001 |
Second Address | Omaha, NE 68198-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 21/09/2015 |