Individual
GREG A GILLHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 S 70TH ST, LINCOLN, NE 68510-2462
(402) 219-8747
(402) 219-8748
Mailing address
555 S 70TH ST, LINCOLN, NE 68510-2462
(402) 421-0904
(402) 421-0946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19515
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03636
BCBS
NE
05
—
100380010A
—
KS
01
—
2663
MIDLANDS CHOICE
—
05
—
2959239
—
IA
05
—
470780857 23
—
NE
01
—
76-00113
UHC
NE
Enumeration date
07/21/2006
Last updated
01/27/2021
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