| Bellevue Family Practice Pc | |
|
2206 Longo Dr Suite 201 Bellevue NE 68005-2977 | |
| (402) 292-9170 | |
| (402) 292-0119 |
| Full Name | Bellevue Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2206 Longo Dr, Bellevue, Nebraska |
| Authorized Official Name and Position | Robert J Sanuik (PRESIDENT) |
| Authorized Official Contact | 4022929170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bellevue Family Practice Pc 2206 Longo Dr Suite 201 Bellevue NE 68005-2977 Ph: (402) 292-9170 | Bellevue Family Practice Pc 2206 Longo Dr Suite 201 Bellevue NE 68005-2977 Ph: (402) 292-9170 |
| NPI Number | 1932153400 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 08/11/2022 |
| Medicare PECOS PAC ID | 3476450032 |
|---|---|
| Medicare Enrollment ID | O20031212000851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932153400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Provider Name | James T Biskup |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811955685 PECOS PAC ID: 3870623655 Enrollment ID: I20100818000409 |
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