Individual
MR. TIMOTHY BLECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 E 11TH ST, SUPERIOR, NE 68978-1101
(402) 879-4781
(402) 879-3365
Mailing address
PO BOX 407, 525 E 11TH ST, SUPERIOR, NE 68978-0407
(402) 879-4781
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
15972
NE
207P00000X
Emergency Medicine Physician
15972
NE
207Q00000X
Family Medicine Physician
Primary
15972
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790777936
—
NE
01
—
32279
BLUE CROSS BLUE SHIELD NE
NE
Enumeration date
08/15/2005
Last updated
09/09/2020
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