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Individual

DR. MARK L MAHLOCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 SOUTH PINE, VALLEY, NE 68064
(402) 359-2277
(402) 359-5432
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20723
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144338872
IA
05
275064
NE
05
47068731761
NE
Enumeration date
08/25/2006
Last updated
01/03/2014
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