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Individual

JOEL KENT VAN DE GRAAFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
EMILE @ 42ND ST, OMAHA, NE 68198-2055
(402) 559-4015
(402) 559-8715
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
215775743
IA
207K00000X
Allergy & Immunology Physician
Primary
30250
NE
207R00000X
Internal Medicine Physician
6567
NE
208000000X
Pediatrics Physician
6567
NE

Other

Enumeration date
06/20/2011
Last updated
11/01/2017
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