Individual
DR. CHARLES BRENT WAKEFIELD II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10707 PACIFIC ST, SUITE 101, OMAHA, NE 68114-4762
(402) 397-7989
(402) 393-7554
Mailing address
PO BOX 8577, OMAHA, NE 68108-0577
(402) 397-7989
(402) 397-8703
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5286
NE
Other
Enumeration date
04/11/2007
Last updated
04/01/2013
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