| NPI | 1073679940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D HEIBEL Md 402-488-6969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 18056) |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: NE 18056) |
| 207ND0900X Dermatology Dermatopathology (Licence: NE 18056) | |
| 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: NE 18056) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: NE 18056) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: NE 18056) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2014-12-11 |