Individual
DR. MATTHEW J MAGNINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 E 23RD ST, FREMONT, NE 68025-2303
(402) 727-7990
(402) 727-1761
Mailing address
1040 N BELL ST, FREMONT, NE 68025-4347
(402) 727-7990
(402) 727-1761
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21554
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050078071
RAILROAD MEDICARE
NE
01
—
34726
BC/BS - NEBRASKA
NE
05
—
911765978-13
—
NE
Enumeration date
05/09/2006
Last updated
03/05/2012
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