Individual
SCOTT J FASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
614 N 108TH CT, OMAHA, NE 68154-1762
(402) 884-7218
(402) 884-7589
Mailing address
614 N 108TH CT, OMAHA, NE 68154-1762
(402) 884-7218
(402) 884-7589
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16872
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34128
BCBSN
NE
Enumeration date
10/25/2006
Last updated
07/08/2007
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