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Individual

DR. JOSEPH PATRICK BAST JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1111 N 102ND CT STE 200, OMAHA, NE 68114-2194
(402) 502-2747
(402) 502-2387
Mailing address
1111 N 102ND CT STE 200, OMAHA, NE 68114-2194
(402) 502-2747
(402) 502-2387

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.116846
IL
207RN0300X
Nephrology Physician
Primary
25014
NE
207RN0300X
Nephrology Physician
38256
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04031
BCBS NE
NE
01
31-00480
SHARE
NE
01
31-00481
SHARE
NE
05
47078164500
NE
05
47078164513
NE
01
P00727910
RR MEDICARE
IA
01
P00740934
RR MEDICARE
NE
Enumeration date
06/04/2008
Last updated
04/10/2019
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