Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 9998 | NE |
NPI | 1013275254 |
---|---|
Provider Name | Dr. Stephen Walker Carveth |
First Address | Lincoln, NE 68516 |
Second Address | Lincoln, NE 68516-2392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2012 |
Last Update Date | 25/04/2012 |