Individual
JYOTI S MAHAPATRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11111 S 84TH ST, PAPILLION, NE 68046-4122
(402) 593-3550
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23692
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0722868
—
IA
05
—
100249951-00
—
NE
01
—
35611
BCBS
NE
01
—
39-02306
SHAREADVANTAGE
NE
01
—
P00374033
RAILROAD MEDICARE
NE
Enumeration date
07/14/2006
Last updated
06/16/2008
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