Organization
BRYAN D BREDTHAUER MD PC
Active
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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