Individual
JEFFREY JOSEPH TIEDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
17788
NE
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
17788
NE
207XS0106X
Orthopaedic Hand Surgery Physician
MD-28688
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06081
BCBS OF NEBRASKA
NE
01
—
09-00185
SHARE ADVANTAG/MERCY RD
NE
01
—
09-01141
SHARE ADVANTAGE/LAKESIDE
NE
05
—
0903179
—
IA
01
—
2463
MIDLANDS CHOICE
NE
05
—
47063010113
—
NE
Enumeration date
06/08/2006
Last updated
12/15/2023
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