Individual
SHIVA SHANKAR VANGIMALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.B.B.S
Contact information
Practice address
7710 MERCY RD STE 2000, OMAHA, NE 68124-2323
(402) 717-9800
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36884
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2017
Last updated
08/19/2025
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