Individual
MARIAN K MEDUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4000
(402) 354-8469
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
082929
IA
363A00000X
Physician Assistant
Primary
1698
NE
363A00000X
Physician Assistant
5601002851
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861444093
—
IA
05
—
47037660432
—
NE
Enumeration date
05/16/2006
Last updated
03/17/2018
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