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Organization
OMAHA VASCULAR SPECIALISTS LLC
Active
Organization
OMAHA VASCULAR SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE A. WALTKE MD (PRESIDENT)
(402) 393-6624
Entity
Organization
Contact information
Practice address
8111 DODGE ST, SUITE 220, OMAHA, NE 68114-4129
(402) 393-6624
(402) 393-6635
Mailing address
8111 DODGE ST, SUITE 220, OMAHA, NE 68114-4129
(402) 393-6624
(402) 393-6635
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
770002841
RAILROAD MEDICARE
IA
01
—
CH4571
RAILROAD MEDICARE
NE
Enumeration date
01/20/2006
Last updated
05/06/2008
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