Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 18435 | NE |
NPI | 1013902386 |
---|---|
Provider Name | Dr. Robert S. Devin |
First Address | Omaha, NE 68131-0058 |
Second Address | Omaha, NE 68122-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 08/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00347 | BCBS (01) | |
F02128 | (02) |