Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 22135 | NE |
NPI | 1083693287 |
---|---|
Provider Name | Mrs. Pamela Santamaria |
First Address | Omaha, NE 68131-2806 |
Second Address | Omaha, NE 68131-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2006 |
Last Update Date | 19/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025242300 | (05) | NE |
2551036 | (05) | IA |
91739 | WELLMARK (01) | |
H57912 | (02) | NE |