Individual
ROBERT G. BONEBRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 N 190TH PLZ, SUITE 2400, ELKHORN, NE 68022-3913
(402) 815-1970
(402) 815-1595
Mailing address
PO BOX 2797, OMAHA, NE 68103-2797
(402) 354-4230
(402) 354-6171
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
19313
NE
207VM0101X
Maternal & Fetal Medicine Physician
Primary
19313
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386758761
—
IA
05
—
470376604-16
—
NE
Enumeration date
08/19/2006
Last updated
12/18/2013
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