Provider Demographics
NPI:1386151314
Name:PRADHAN, DINESH (MD)
Entity type:Individual
Prefix:DR
First Name:DINESH
Middle Name:
Last Name:PRADHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983135 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3135
Mailing Address - Country:US
Mailing Address - Phone:402-559-7816
Mailing Address - Fax:402-559-6018
Practice Address - Street 1:983135 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-6898
Practice Address - Country:US
Practice Address - Phone:402-559-7672
Practice Address - Fax:402-559-6018
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE35809207ZP0102X
PAMT206827207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology