Individual
OLEG N. MILITSAKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8303 DODGE ST, SUITE # 304, OMAHA, NE 68114-4108
(402) 354-5048
(402) 354-2585
Mailing address
PO BOX 10190, VIRGINIA BEACH, VA 23450-0190
(800) 477-5240
(757) 463-6572
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
24133
NE
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
24133
NE
208600000X
Surgery Physician
24133
NE
2086X0206X
Surgical Oncology Physician
24133
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025044400
—
NE
05
—
1306879291
—
IA
05
—
1306879291
—
MO
Enumeration date
07/07/2006
Last updated
12/16/2013
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