Organization
DERMATOLOGY SPECIALISTS OF OMAHA LLC
Active
Other names
Dermatology Surgery Center Group, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DAMITA K GILFORD (DIRECTOR OF BUSINESS OFFICE SERVICE)
(402) 763-1518
Entity
Organization
Contact information
Practice address
909 N 96TH ST STE 201, OMAHA, NE 68114-2508
(402) 330-4555
(402) 330-4626
Mailing address
909 N 96TH ST STE 201, OMAHA, NE 68114-2508
(402) 330-4555
(402) 330-4626
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099992
MEDICARE GROUP
NE
05
—
10025555000
—
NE
Enumeration date
07/24/2007
Last updated
05/10/2022
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