Provider Demographics
NPI:1760820575
Name:HEMMINGS, STEFAN CERU (MB, BS)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:CERU
Last Name:HEMMINGS
Suffix:
Gender:M
Credentials:MB, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD STE 426
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2323
Mailing Address - Country:US
Mailing Address - Phone:402-343-8650
Mailing Address - Fax:401-343-8545
Practice Address - Street 1:7710 MERCY RD STE 426
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2323
Practice Address - Country:US
Practice Address - Phone:402-343-8650
Practice Address - Fax:401-343-8545
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-53109207RN0300X
ARE-10971207RN0300X
NE36321207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR664751OtherMEDICARE
AR229303001Medicaid