Individual
MICHAEL FACCIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8200 DODGE ST, OMAHA, NE 68114-4113
(531) 256-9433
Mailing address
8200 DODGE ST, OMAHA, NE 68114-4113
(531) 256-9433
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35698
NE
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35698
NE
Other
Enumeration date
04/04/2017
Last updated
01/04/2024
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