Individual
SOUBRATA V RAIKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1439 E 23RD ST, FREMONT, NE 68025-2433
(402) 721-8895
(402) 721-6663
Mailing address
1439 E 23RD ST, FREMONT, NE 68025-2433
(402) 721-8895
(402) 721-6663
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
21157
NE
208VP0014X
Interventional Pain Medicine Physician
Primary
21157
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025199800
—
NE
Enumeration date
11/20/2006
Last updated
12/01/2011
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