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Individual

MANIAMPARAMPIL SHASHIDHARAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
9850 NICHOLAS ST, SUITE 100, OMAHA, NE 68114-2186
(402) 343-1122
(402) 343-1177
Mailing address
9850 NICHOLAS ST, SUITE 100, OMAHA, NE 68114-2186
(402) 343-1122
(402) 343-1177

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
20913
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47053395013
NE
05
47053395014
NE
Enumeration date
07/22/2005
Last updated
07/08/2007
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