Individual
JAYAN VASUDEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS,ABP
Contact information
Practice address
601 N 30TH ST., SUITE 6820, OMAHA, NE 68131
(402) 280-4580
(402) 280-4159
Mailing address
16602 CAPITOL PLZ APT 3, OMAHA, NE 68118-4014
(402) 547-6907
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23006
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47073897408
—
NE
Enumeration date
07/20/2006
Last updated
01/29/2013
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