Organization
WAYNE V VIDETICH DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE V VIDETICH DPM (PRESIDENT)
(402) 477-3200
Entity
Organization
Contact information
Practice address
2710 SOUTH ST, LINCOLN, NE 68502-3252
(402) 477-3200
(402) 477-3561
Mailing address
2710 SOUTH ST, LINCOLN, NE 68502-3252
(402) 477-3200
(402) 477-3561
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
NE134
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2545
BLUE CROSS/BLUE SHIELD
NE
01
—
88434
COVENTRY
NE
01
—
NE134
MUTUAL OF OMAHA
NE
Enumeration date
06/10/2008
Last updated
06/10/2008
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