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Individual

HELEN O FASANYA-UPTAGRAFT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8901 INDIAN HILLS DR, SUITE 200, OMAHA, NE 68114-4029
(402) 397-7057
Mailing address
8901 INDIAN HILLS DR, SUITE 200, OMAHA, NE 68114-4029
(402) 397-7057

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011-00251
NC
207RG0100X
Gastroenterology Physician
Primary
27830
NE
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1598920415
NE
Enumeration date
07/21/2008
Last updated
06/18/2014
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