Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 12865 | NE |
NPI | 1013912203 |
---|---|
Provider Name | John D Kugler |
First Address | Omaha, NE 68124-1853 |
Second Address | Omaha, NE 68114-4113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
47064448313 | (05) | NE |
E44186 | (02) |