Individual
BRENT ALLEN WILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6041 VILLAGE DR, SUITE 150, LINCOLN, NE 68516-6619
(402) 423-1900
(402) 423-5991
Mailing address
6041 VILLAGE DR, SUITE 150, LINCOLN, NE 68516-6619
(402) 423-1900
(402) 423-5991
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17210
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00365
BCBS
NE
05
—
47081021213
—
NE
Enumeration date
02/06/2006
Last updated
07/09/2007
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