Most Relevant Information
Provider Data
| NPI Number: | 1003018821 |
| Provider Name: | MARIO EDWARD BACCARI M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 11483 |
Most Important Dates
| Enumeration Date: | 06/04/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
9475 PAULINE ST
OMAHA
NE
681243838
Practice Location Phone/Fax
| Phone: | 4023976145 |
| Fax: |
Provider Mailing Location
9475 PAULINE ST
OMAHA
NE
681243838
Provider Mailing Phone/Fax
| Phone: | 4023976145 |
| Fax: |