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Organization

BRYAN D BREDTHAUER MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRYAN D BREDTHAUER M.D. (PRESIDENT)
(402) 492-9922
Entity
Organization

Contact information

Practice address
11819 MIRACLE HILLS DR, STE 203, OMAHA, NE 68154-5308
(402) 492-9922
(402) 492-9944
Mailing address
11819 MIRACLE HILLS DR, STE 203, OMAHA, NE 68154-5308
(402) 492-9922
(402) 492-9944

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17324
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00086
BCBS NE
NE
01
200023116
RR MEDICARE
NE
01
261369
MEDICARE GROUP PTAN
NE
01
DQ4240
RR MEDICARE GROUP PTAN
NE
Enumeration date
11/09/2006
Last updated
09/14/2010
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