Organization
MIDWEST DERMATOLOGY CLINIC, P.C.
Active
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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