Provider Demographics
NPI:1144074840
Name:MODI, NISHI MANOJKUMAR (MBBS)
Entity type:Individual
Prefix:
First Name:NISHI
Middle Name:MANOJKUMAR
Last Name:MODI
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CREIGHTON UNIVERSITY SCHOOL OF MEDICINE, 7701 MERCY ROA
Mailing Address - Street 2:SUITE 601
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2370
Mailing Address - Country:US
Mailing Address - Phone:402-280-4195
Mailing Address - Fax:402-280-1184
Practice Address - Street 1:CREIGHTON UNIVERSITY SCHOOL OF MEDICINE, 7701 MERCY ROA
Practice Address - Street 2:SUITE 601
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2370
Practice Address - Country:US
Practice Address - Phone:402-280-4195
Practice Address - Fax:402-280-1184
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program