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Individual

MS. MARY C DEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
18018 BURKE STREET, ELKHORN, NE 68022-4417
(402) 573-7337
Mailing address
16811 BURKE STREET, STE 101, OMAHA, NE 68118
(402) 573-7337

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
21119
NE
208000000X
Pediatrics Physician
Primary
21199
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0538579
IA
05
1200405
NE
05
1200408
NE
05
1200590
NE
05
1200591
NE
05
1200592
NE
05
1201173
NE
05
1201454
NE
05
1538579
IA
01
24985
MIDLANDS CHOICE
NE
01
34043
BCBS OF NEBRASKA
NE
Enumeration date
12/07/2006
Last updated
10/11/2012
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