Individual
DR. WAYNE V VIDETICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2710 SOUTH ST, LINCOLN, NE 68502-3252
(402) 477-3200
(402) 477-3561
Mailing address
2710 SOUTH ST, LINCOLN, NE 68502-3252
(402) 477-3200
(402) 477-3561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NE134
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2545
BLUE CROSS/BLUE SHIELD
NE
05
—
47061112100
—
NE
05
—
6800630
—
SD
01
—
NE134
MUTUAL OF OMAHA
NE
Enumeration date
07/16/2006
Last updated
11/16/2007
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