Organization · NPI-2

23rd Family Med LLC

Family Medicine · Fremont, NE

NPI number1740573989
StatusActive
Last updated in NPPESJun 28, 2011

Details

NPI
1740573989
Entity type
Organization (NPI-2)
Legal business name
23rd Family Med LLC
Organization subpart
No
Enumeration date
May 20, 2011
Last updated
Jun 28, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

350 W 23rd St
Suite D
Fremont, NE 68025-2592

Phone 402-721-8800 · Fax 402-753-6096

Mailing address

350 W 23rd St
Suite D
Fremont, NE 68025-2592

Phone 402-721-8800 · Fax 402-753-6096

Authorized official

Milo V Anderson
Physician/Owner
4027218800

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