Individual
MELVIN ALBERT CHURCHILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 PINE LAKE RD, SUITE 120, LINCOLN, NE 68516-5497
(402) 420-1212
(402) 328-0961
Mailing address
3901 PINE LAKE RD, SUITE 120, LINCOLN, NE 68516-5497
(402) 420-1212
(402) 328-0961
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
12536
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00323/01942
BLUE SHIELD PIN/GROUP
—
01
—
110047260/CO4240
RAILROAD MEDICARE PIN/GRP
—
Enumeration date
01/25/2006
Last updated
04/29/2021
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