Provider Demographics
NPI:1083663751
Name:HEISER, DAVID PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PATRICK
Last Name:HEISER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:575 S 70TH
Mailing Address - Street 2:STE 200, NEBRASKA ORTHOPAEDIC AND SPORTS MEDICINE PD
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2471
Mailing Address - Country:US
Mailing Address - Phone:402-488-3322
Mailing Address - Fax:402-488-1172
Practice Address - Street 1:575 S 70TH
Practice Address - Street 2:STE 200, NEBRASKA ORTHOPAEDIC AND SPORTS MEDICINE PD
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2471
Practice Address - Country:US
Practice Address - Phone:402-488-3322
Practice Address - Fax:402-488-1172
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE12675207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1083663751Medicaid
NE47070309913Medicaid
IA1285683870Medicaid
IA1285683870Medicaid
MO1083663751Medicaid