Basic Information
Provider Information
NPI: 1477568137
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SKAF
FirstName: EYAD
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7500 MERCY RD
Address2:  
City: OMAHA
State: NE
PostalCode: 681242319
CountryCode: US
TelephoneNumber: 8555244001
FaxNumber: 4023985589
Practice Location
Address1: 7500 MERCY RD
Address2:  
City: OMAHA
State: NE
PostalCode: 681242319
CountryCode: US
TelephoneNumber: 4023985880
FaxNumber: 4023985589
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 04/11/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XMD-39793IAY Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X26343NEN Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
27985490005FL MEDICAID
8197055205CO MEDICAID


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