Provider Demographics
NPI:1750269023
Name:SDAH, NAW
Entity type:Individual
Prefix:
First Name:NAW
Middle Name:
Last Name:SDAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 N 64TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-1908
Mailing Address - Country:US
Mailing Address - Phone:402-609-6645
Mailing Address - Fax:
Practice Address - Street 1:510 S 24TH ST APT 3
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1203
Practice Address - Country:US
Practice Address - Phone:612-425-9557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant