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Individual

ANDREW M COUGHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8303 DODGE ST, SUITE 304, OMAHA, NE 68114-4108
(402) 354-5048
(402) 354-2585
Mailing address
PO BOX 10190, VIRGINIA BEACH, VA 23450-0190
(800) 477-5240
(757) 463-6572

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
27214
NE
207Y00000X
Otolaryngology Physician
BP10032053
TX
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
27214
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100250444-00
NE
05
10026485711
NE
05
1578714440
IA
Enumeration date
10/08/2008
Last updated
01/24/2018
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