Individual
DR. MARTIN M MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7100 W CENTER RD, OMAHA, NE 68106-2700
(402) 506-9106
(402) 858-7104
Mailing address
7100 W CENTER RD, OMAHA, NE 68106-2700
(402) 506-9106
(402) 858-7104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14017
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
828013494
TRAVELERS RR MEDICARE
NE
Enumeration date
08/24/2006
Last updated
09/10/2015
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