Individual
DR. PATRICIA J CHUDOMELKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11819 MIRACLE HILLS DR, SUITE 105, OMAHA, NE 68154-4428
(402) 978-5156
(402) 341-3616
Mailing address
PO BOX 30029, OMAHA, NE 68103-1129
(402) 978-5156
(402) 341-3616
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
20620
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515882
—
IA
05
—
47081215600
—
NE
Enumeration date
06/07/2006
Last updated
09/29/2014
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