Provider Demographics
NPI:1144630468
Name:SIMONE, PETER DAVID (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:DAVID
Last Name:SIMONE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:16820 FRANCES ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2391
Mailing Address - Country:US
Mailing Address - Phone:402-933-6600
Mailing Address - Fax:402-933-7123
Practice Address - Street 1:16820 FRANCES ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2391
Practice Address - Country:US
Practice Address - Phone:402-933-6600
Practice Address - Fax:402-933-7123
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32490207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology