Individual
DR. STACEY T MCMANIGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4540
Mailing address
16526 MARCY ST, OMAHA, NE 68118-2726
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20270
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1514430
—
IA
05
—
47037660422
—
NE
Enumeration date
08/30/2006
Last updated
07/08/2007
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