Individual
GUILLERMO HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 N 103RD PLZ, SUITE 102, OMAHA, NE 68114-1114
(402) 354-0120
(402) 354-0125
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17643
NE
207R00000X
Internal Medicine Physician
25333
IA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
17643
NE
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25333
IA
207RP1001X
Pulmonary Disease Physician
Primary
17643
NE
207RP1001X
Pulmonary Disease Physician
25333
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026480109
—
NE
05
—
1144224841
—
IA
Enumeration date
06/09/2005
Last updated
08/22/2016
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