Organization
ADVANCED DERMATOLOGY OF THE MIDLANDS PC
Active
Organization
ADVANCED DERMATOLOGY OF THE MIDLANDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M. SHEHAN MD, FAAD (PRESIDENT)
(402) 933-3770
Entity
Organization
Contact information
Practice address
12910 PIERCE ST STE 120, OMAHA, NE 68144-1106
(402) 933-3770
(402) 933-3633
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100263840-00
—
NE
05
—
1497182273
—
IA
Enumeration date
10/10/2013
Last updated
02/06/2019
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