Individual
MR. SAMUEL J DOSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
6900 A ST, STE 100, LINCOLN, NE 68510-4120
(402) 436-2000
(402) 436-2090
Mailing address
6900 A ST, LINCOLN, NE 68510-4120
(402) 436-2000
(402) 434-2691
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1217
NE
363AS0400X
Surgical Physician Assistant
Primary
1217
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247112
MIDLANDS CHOICE
NE
01
—
91177983268510A019
TRI CARE
NE
Enumeration date
02/17/2006
Last updated
09/04/2017
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