Individual
ANTARA PRATAP POTHULOORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8901 W DODGE RD, STE. 200B, OMAHA, NE 68114-3327
(402) 354-1700
(402) 354-2055
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25791
NE
207V00000X
Obstetrics & Gynecology Physician
47814
KY
207V00000X
Obstetrics & Gynecology Physician
50575
CO
207V00000X
Obstetrics & Gynecology Physician
A104060
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026301600
—
NE
05
—
10026480100
—
NE
05
—
1710131305
—
IA
05
—
47068731799
—
NE
Enumeration date
11/09/2008
Last updated
01/17/2017
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