Provider Demographics
NPI:1427134659
Name:TYNDALL, STEVE H (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:H
Last Name:TYNDALL
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 1:7440 S 91ST ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9797
Mailing Address - Country:US
Mailing Address - Phone:402-489-6555
Mailing Address - Fax:402-328-3770
Practice Address - Street 1:7440 S 91ST ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9797
Practice Address - Country:US
Practice Address - Phone:402-489-6555
Practice Address - Fax:402-328-3770
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE184852086S0129X
KS04-267492086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026072500Medicaid
NE47070592305Medicaid
NE10026072400Medicaid
NE47070592302Medicaid
NE10026072200Medicaid
NE47070592300Medicaid
NE47070592301Medicaid
KS100295930AMedicaid
IA1925008Medicaid
NE47070592313Medicaid
NE10026072600Medicaid
NE47070592306Medicaid
NE10026072000Medicaid
NE10026072300Medicaid
NE47070592302Medicaid
NENA1079007Medicare PIN
NENA1939027Medicare PIN
NE47070592305Medicaid
KSKA2283004Medicare PIN
F76368Medicare UPIN
NE47070592300Medicaid
NE47070592313Medicaid