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Organization

MIDWEST DERMATOLOGY CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COLLEEN M MCCOY (PRACTICE ADMINISTRATOR)
(531) 710-4063
Entity
Organization

Contact information

Practice address
8601 W DODGE RD STE 240, OMAHA, NE 68114-3430
(402) 933-0800
(513) 721-2918
Mailing address
2323 S 171ST ST STE 100, OMAHA, NE 68130-4651
(402) 933-0800
(531) 721-2918

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2941
BLUE CROSS BLUE SHIELD
NE
01
CO3220
RAIL ROAD MEDICARE
NE
Enumeration date
01/18/2006
Last updated
01/05/2026
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